Sexually Transmitted Infections among HIV-1-Discordant Couples
Identifieur interne : 005227 ( Main/Exploration ); précédent : 005226; suivant : 005228Sexually Transmitted Infections among HIV-1-Discordant Couples
Auteurs : Brandon L. Guthrie [États-Unis] ; James N. Kiarie [Kenya] ; Susan Morrison [États-Unis] ; Grace C. John-Stewart [États-Unis] ; John Kinuthia [Kenya] ; William L. H. Whittington [États-Unis] ; Carey Farquhar [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2009.
Abstract
More new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexually transmitted infections (STIs) may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples.
HIV-1-discordant couples in which HIV-1-infected partners were HSV-2-seropositive were tested for syphilis, chlamydia, gonorrhea, and trichomoniasis, and HIV-1-uninfected partners were tested for HSV-2. We assessed sociodemographic, behavioral, and biological correlates of a current STI.
Of 416 couples enrolled, 16% were affected by a treatable STI, and among these both partners were infected in 17% of couples. A treatable STI was found in 46 (11%) females and 30 (7%) males. The most prevalent infections were trichomoniasis (5.9%) and syphilis (2.6%). Participants were 5.9-fold more likely to have an STI if their partner had an STI (P<0.01), and STIs were more common among those reporting any unprotected sex (OR = 2.43; P<0.01) and those with low education (OR = 3.00; P<0.01). Among HIV-1-uninfected participants with an HSV-2-seropositive partner, females were significantly more likely to be HSV-2-seropositive than males (78% versus 50%, P<0.01).
Treatable STIs were common among HIV-1-discordant couples and the majority of couples affected by an STI were discordant for the STI, with relatively high HSV-2 discordance. Awareness of STI correlates and treatment of both partners may reduce HIV-1 transmission.
ClinicalTrials.gov NCT00194519
Url:
DOI: 10.1371/journal.pone.0008276
PubMed: 20011596
PubMed Central: 2788224
Affiliations:
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Guthrie</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Epidemiology, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Kiarie, James N" sort="Kiarie, James N" uniqKey="Kiarie J" first="James N." last="Kiarie">James N. Kiarie</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Morrison, Susan" sort="Morrison, Susan" uniqKey="Morrison S" first="Susan" last="Morrison">Susan Morrison</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Medicine, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Department of Global Health, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Global Health, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="John Stewart, Grace C" sort="John Stewart, Grace C" uniqKey="John Stewart G" first="Grace C." last="John-Stewart">Grace C. John-Stewart</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Epidemiology, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Medicine, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Department of Global Health, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Global Health, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Kinuthia, John" sort="Kinuthia, John" uniqKey="Kinuthia J" first="John" last="Kinuthia">John Kinuthia</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Whittington, William L H" sort="Whittington, William L H" uniqKey="Whittington W" first="William L. H." last="Whittington">William L. H. Whittington</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Medicine, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Farquhar, Carey" sort="Farquhar, Carey" uniqKey="Farquhar C" first="Carey" last="Farquhar">Carey Farquhar</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Epidemiology, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Medicine, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>More new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexually transmitted infections (STIs) may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples.</p></sec><sec><title>Methods</title><p>HIV-1-discordant couples in which HIV-1-infected partners were HSV-2-seropositive were tested for syphilis, chlamydia, gonorrhea, and trichomoniasis, and HIV-1-uninfected partners were tested for HSV-2. We assessed sociodemographic, behavioral, and biological correlates of a current STI.</p></sec><sec><title>Results</title><p>Of 416 couples enrolled, 16% were affected by a treatable STI, and among these both partners were infected in 17% of couples. A treatable STI was found in 46 (11%) females and 30 (7%) males. The most prevalent infections were trichomoniasis (5.9%) and syphilis (2.6%). Participants were 5.9-fold more likely to have an STI if their partner had an STI (P<0.01), and STIs were more common among those reporting any unprotected sex (OR = 2.43; P<0.01) and those with low education (OR = 3.00; P<0.01). Among HIV-1-uninfected participants with an HSV-2-seropositive partner, females were significantly more likely to be HSV-2-seropositive than males (78% versus 50%, P<0.01).</p></sec><sec><title>Conclusions</title><p>Treatable STIs were common among HIV-1-discordant couples and the majority of couples affected by an STI were discordant for the STI, with relatively high HSV-2 discordance. Awareness of STI correlates and treatment of both partners may reduce HIV-1 transmission.</p></sec><sec><title>Trial Registration</title><p>ClinicalTrials.gov NCT00194519</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Montaner, Js" uniqKey="Montaner J">JS Montaner</name></author><author><name sortKey="Hogg, R" uniqKey="Hogg R">R Hogg</name></author><author><name sortKey="Wood, E" uniqKey="Wood E">E Wood</name></author><author><name sortKey="Kerr, T" uniqKey="Kerr T">T Kerr</name></author><author><name sortKey="Tyndall, M" uniqKey="Tyndall M">M Tyndall</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bunnell, R" uniqKey="Bunnell R">R Bunnell</name></author><author><name sortKey="Ekwaru, Jp" uniqKey="Ekwaru J">JP Ekwaru</name></author><author><name sortKey="Solberg, P" uniqKey="Solberg P">P Solberg</name></author><author><name sortKey="Wamai, N" uniqKey="Wamai N">N 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Weiss</name></author><author><name sortKey="Buve, A" uniqKey="Buve A">A Buve</name></author><author><name sortKey="Robinson, Nj" uniqKey="Robinson N">NJ Robinson</name></author><author><name sortKey="Van Dyck, E" uniqKey="Van Dyck E">E Van Dyck</name></author><author><name sortKey="Kahindo, M" uniqKey="Kahindo M">M Kahindo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abu Raddad, Lj" uniqKey="Abu Raddad L">LJ Abu-Raddad</name></author><author><name sortKey="Longini, Im" uniqKey="Longini I">IM, Longini</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Kenya</li><li>États-Unis</li></country><region><li>Washington (État)</li></region><settlement><li>Seattle</li></settlement><orgName><li>Université de Washington</li></orgName></list><tree><country name="États-Unis"><region name="Washington (État)"><name sortKey="Guthrie, Brandon L" sort="Guthrie, Brandon L" uniqKey="Guthrie B" first="Brandon L." last="Guthrie">Brandon L. Guthrie</name></region><name sortKey="Farquhar, Carey" sort="Farquhar, Carey" uniqKey="Farquhar C" first="Carey" last="Farquhar">Carey Farquhar</name><name sortKey="Farquhar, Carey" sort="Farquhar, Carey" uniqKey="Farquhar C" first="Carey" last="Farquhar">Carey Farquhar</name><name sortKey="John Stewart, Grace C" sort="John Stewart, Grace C" uniqKey="John Stewart G" first="Grace C." last="John-Stewart">Grace C. John-Stewart</name><name sortKey="John Stewart, Grace C" sort="John Stewart, Grace C" uniqKey="John Stewart G" first="Grace C." last="John-Stewart">Grace C. John-Stewart</name><name sortKey="John Stewart, Grace C" sort="John Stewart, Grace C" uniqKey="John Stewart G" first="Grace C." last="John-Stewart">Grace C. John-Stewart</name><name sortKey="Morrison, Susan" sort="Morrison, Susan" uniqKey="Morrison S" first="Susan" last="Morrison">Susan Morrison</name><name sortKey="Morrison, Susan" sort="Morrison, Susan" uniqKey="Morrison S" first="Susan" last="Morrison">Susan Morrison</name><name sortKey="Whittington, William L H" sort="Whittington, William L H" uniqKey="Whittington W" first="William L. H." last="Whittington">William L. H. Whittington</name></country><country name="Kenya"><noRegion><name sortKey="Kiarie, James N" sort="Kiarie, James N" uniqKey="Kiarie J" first="James N." last="Kiarie">James N. Kiarie</name></noRegion><name sortKey="Kinuthia, John" sort="Kinuthia, John" uniqKey="Kinuthia J" first="John" last="Kinuthia">John Kinuthia</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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