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. 2021 Jan-Feb;25(1):101044.
doi: 10.1016/j.bjid.2020.101044. Epub 2021 Jan 6.

Sexually transmitted infections among women living with HIV in a Brazilian city

Neide Aparecida Tosato Boldrini  1 , Lays Paula Bondi Volpini  2 , Luciana Bueno Freitas  2 , Liliana Cruz Spano  2 , Carlos Musso  3 , Maria Carmen Lopes Ferreira Silva Santos  3 , Helena Lucia Barroso Dos Reis  4 , Angelica Espinosa Miranda  2
Affiliations

Sexually transmitted infections among women living with HIV in a Brazilian city

Neide Aparecida Tosato Boldrini et al. Braz J Infect Dis. 2021 Jan-Feb.

Abstract

Background: Clinical improvements following highly active antiretroviral therapy (HAART) may increase high-risk behaviors resulting in sexually transmitted infections (STI). Optimism related to the success of HAART in slowing disease progression, reducing viral load, and improving health status might be important factors for increasing sexual risk behaviors such as less use of condoms.

Objective: To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B and C, high-risk HPV, and cervical cytological abnormalities among women living with HIV (WLHIV) who attended a Reference Center for STI/AIDS in Brazil.

Methods: A cross-sectional study was conducted among 151 WLHIV attending an STI Clinic in Vitória city, Brazil. A structured questionnaire, including demographic, behavioral, and clinical information, was used for data collection. Serological tests for HIV, syphilis, hepatitis C and B, CD4 counts, and viral load determination were performed. Cervical samples were collected for cytology and real-time PCR for HPV,Chlamydia, and Neisseria gonorrhoeae.

Results: In this study, 59% of women had at least one diagnosed STI at the time of the first clinic visit; 31% had clinical forms of anogenital HPV, 10% syphilis, 8%Neisseria gonorrhoeae, 5.0% trichomoniasis, 3% Chlamydia trachomatis, 1% hepatitis B, and 1% hepatitis C; 6.7% of the women presented with cervical cytological abnormalities. Furthermore, 46.3% of women had HR-HPV, and 17.6% had HPV 16/18. Only 5% of the women had a CD4 count <200 cells/mm3, 61.6% had undetectable HIV viral load, and 81.3% were currently on HAART.

Conclusion: A high prevalence of STI and HR-HPV infections were observed among HIV-infected women in this investigation. Prevention programs need to focus on counseling WLHIV and their regular partners with focused interventions such as couples counseling and education programs.

Keywords: Highly active antiretroviral therapy; Human immunodeficiency virus (HIV); Sexual behavior; Sexually Transmitted Infections (STIs).

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Fig. 1
Prevalence of STIs at the time of the first clinic visit.
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