Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 1;14(7):e0218349.
doi: 10.1371/journal.pone.0218349. eCollection 2019.

Prevalence and correlates of sexually transmitted infections in pregnancy in HIV-infected and- uninfected women in Cape Town, South Africa

Dvora L Joseph Davey  1   2 , Dorothy C Nyemba  2 , Yolanda Gomba  2 , Linda-Gail Bekker  3 , Sophia Taleghani  4 , David J DiTullio  4 , David Shabsovich  4 , Pamina M Gorbach  1   4 , Thomas J Coates  4 , Jeffrey D Klausner  4 , Landon Myer  2
Affiliations

Prevalence and correlates of sexually transmitted infections in pregnancy in HIV-infected and- uninfected women in Cape Town, South Africa

Dvora L Joseph Davey et al. PLoS One. .

Abstract

Objectives: Sexually transmitted infections (STIs) are associated with adverse outcomes in pregnancy, including mother-to-child HIV transmission. Yet there are limited data on the prevalence and correlates of STI in pregnant women by HIV status in low- and middle-income countries, where syndromic STI management is routine.

Methods: Between November 2017 and July 2018, we conducted a cross-sectional study of consecutive pregnant women making their first visit to a public sector antenatal clinic (ANC) in Cape Town. We interviewed women ≥18 years and tested them for Chlamydia trachomatis (CT), Neisseria gonorrhoea (NG) and Trichomonas vaginalis (TV) using Xpert assays (Cepheid, USA); results of syphilis serology came from routine testing records. We used multivariable logistic regression to identify correlates of STI in pregnancy.

Results: In 242 women (median age 29 years [IQR = 24-34], median gestation 19 weeks [IQR = 14-24]) 44% were HIV-infected. Almost all reported vaginal sex during pregnancy (93%). Prevalence of any STI was 32%: 39% in HIV-infected women vs. 28% in HIV-uninfected women (p = 0.036). The most common infection was CT (20%) followed by TV (15%), then NG (5.8%). Of the 78 women diagnosed with a STI, 7 (9%) were identified and treated syndromically in ANC. Adjusting for age and gestational age, HIV-infection (aOR = 1.89; 95% CI = 1.02-3.67), being unmarried or not cohabiting with the fetus' father (aOR = 2.19; 95% CI = 1.16-4.12), and having STI symptoms in the past three days (aOR = 6.60; 95% CI = 2.08-20.95) were associated with STI diagnosis.

Conclusion: We found a high prevalence of treatable STIs in pregnancy among pregnant women, especially in HIV-infected women. Few women were identified and treated in pregnancy.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Prevalence of STI by type at first antenatal care visit in pregnant women in Cape Town, South Africa (n = 242).
STIs include: Chlamydia trachomatis (CT), Neisseria gonorrhoea (NG) and Trichomonas vaginalis (TV).
See this image and copyright information in PMC

References

    1. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLoS One. 2015;10(12):e0143304 10.1371/journal.pone.0143304 - DOI - PMC - PubMed
    1. Joseph Davey DL, Shull HI, Billings JD, Wang D, Adachi K, Klausner JD. Prevalence of Curable Sexually Transmitted Infections in Pregnant Women in Low- and Middle-Income Countries From 2010 to 2015: A Systematic Review. Sexually transmitted diseases. 2016;43(7):450–8. 10.1097/OLQ.0000000000000460 - DOI - PMC - PubMed
    1. Adachi K, Nielsen-Saines K, Klausner JD. Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia. Biomed Res Int. 2016;2016:9315757 10.1155/2016/9315757 - DOI - PMC - PubMed
    1. Adachi K, Klausner JD, Xu J, Ank B, Bristow CC, Morgado MG, et al. Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes. Pediatr Infect Dis J. 2016;35(8):894–900. 10.1097/INF.0000000000001199 - DOI - PMC - PubMed
    1. Moodley P, Sturm AW. Sexually transmitted infections, adverse pregnancy outcome and neonatal infection. Seminars in Neonatology. 2000;5(3):255–69. 10.1053/siny.2000.0026. - DOI - PubMed

Publication types

MeSH terms