TY - JOUR
T1 - Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil
T2 - Self-collected vs. Clinician-collected samples
AU - Rodrigues, Luana L.S.
AU - Hardick, Justin
AU - Nicol, Alcina F.
AU - Morgado, Mariza G.
AU - Martinelli, Katrini G.
AU - De Paula, Vanessa S.
AU - Pilotto, José H.
AU - Gaydos, Charlotte A.
N1 - Funding Information:
L. L. S. R. was supported a grant, process number 88881.131796/2016-01, from CAPES Foundation - Brazil. C. A. G. was supported by, grant number U54EB007958, of the National Institute of Biomedical Imaging and Bioengineering (NIBIB), and, grant number U-01068613, of the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH). A. F. N. was supported by, grant number 401810/2015-1, the Programa Estratégico de Apoio a Pesquisa em Saúde (PAPES VII), Fundação Oswaldo Cruz (FIOCRUZ)/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2019 Rodrigues et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/4
Y1 - 2019/4
N2 - The anogenital prevalence of sexually transmitted infections (STIs) and the use of cervico-vaginal self-collected vs. clinician-collected samples were evaluated for the diagnosis of human immunodeficiency virus (HIV)-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil. We recruited 153 women for a cross-sectional study (112 HIV-uninfected and 41 HIV-infected) who sought health services. Anal and cervical scrapings and cervico-vaginal self-collection samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium. A syphilis test was also performed. Risk factors for STIs were identified by multivariate analysis. The overall prevalence of STIs was 30.4% (34/112) in HIV-uninfected women and 24.4% (10/41) in HIV-infected women. Anogenital Chlamydia trachomatis infection was the most prevalent in both groups of women (20.5% vs 19.5%). There was significant agreement for each STI between self-collected and clinician-collected samples: 91.7%, kappa 0.67, 95% confidence interval (CI) 0.49–0.85 for Chlamydia trachomatis; 99.2%, kappa 0.85, 95% CI 0.57–1.00 for Neisseria gonorrhoeae; 97.7%, kappa 0.39, 95% CI -0.16–0.94 for Trichomonas vaginalis; and 94.7%, kappa 0.51, 95% CI 0.20–0.82 for Mycoplasma genitalium. Women with human papillomavirus had coinfection or multiple infections with other STIs. Risk factors for STIs were being 25 years old, being employed or a student, reporting a history of STI and having a positive HPV test. A high prevalence of STIs in women in the Tapajós region was found. Cervico-vaginal self-collection is a useful tool for STI screening and can be used in prevention control programs in low-resource settings, such as in northern Brazil.
AB - The anogenital prevalence of sexually transmitted infections (STIs) and the use of cervico-vaginal self-collected vs. clinician-collected samples were evaluated for the diagnosis of human immunodeficiency virus (HIV)-infected and HIV-uninfected women in the Tapajós region, Amazon, Brazil. We recruited 153 women for a cross-sectional study (112 HIV-uninfected and 41 HIV-infected) who sought health services. Anal and cervical scrapings and cervico-vaginal self-collection samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium. A syphilis test was also performed. Risk factors for STIs were identified by multivariate analysis. The overall prevalence of STIs was 30.4% (34/112) in HIV-uninfected women and 24.4% (10/41) in HIV-infected women. Anogenital Chlamydia trachomatis infection was the most prevalent in both groups of women (20.5% vs 19.5%). There was significant agreement for each STI between self-collected and clinician-collected samples: 91.7%, kappa 0.67, 95% confidence interval (CI) 0.49–0.85 for Chlamydia trachomatis; 99.2%, kappa 0.85, 95% CI 0.57–1.00 for Neisseria gonorrhoeae; 97.7%, kappa 0.39, 95% CI -0.16–0.94 for Trichomonas vaginalis; and 94.7%, kappa 0.51, 95% CI 0.20–0.82 for Mycoplasma genitalium. Women with human papillomavirus had coinfection or multiple infections with other STIs. Risk factors for STIs were being 25 years old, being employed or a student, reporting a history of STI and having a positive HPV test. A high prevalence of STIs in women in the Tapajós region was found. Cervico-vaginal self-collection is a useful tool for STI screening and can be used in prevention control programs in low-resource settings, such as in northern Brazil.
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U2 - 10.1371/journal.pone.0215001
DO - 10.1371/journal.pone.0215001
M3 - Article
C2 - 31013277
AN - SCOPUS:85065226455
SN - 1932-6203
VL - 14
JO - PloS one
JF - PloS one
IS - 4
M1 - e0215001
ER -