Article information
Abstract
Objectives
To describe the epidemiological profile, risk behaviors, and the prior history of sexually transmitted diseases (STDs) in women living with acquired immunodeficiency syndrome (AIDS).
MethodsCross-sectional study, performed at the Centro de Referência e Treinamento em DST/AIDS of São Paulo. The social, demographic, behavioral, and clinical data such as age, schooling, marital status, age at first sexual intercourse, number of sexual partners, parity, use of drugs, time of HIV diagnosis, CD4 count, and viral load determination were abstracted from the medical records of women living with AIDS who had gynecological consultation scheduled in the period from June 2008 to May 2009.
ResultsOut of 710 women who were scheduled to a gynecological consultation during the period of the study, 598 were included. Previous STD was documented for 364 (60.9%; 95% CI: 56.9%–64.8%) women. The associated factors with previous STDs and their respective risks were: human development index (HDI) < 0.50 (ORaj=5.5; 95% CI: 2.8–11.0); non-white race (ORaj=5.2; 95% CI: 2.5–11.0); first sexual intercourse at or before 15 years of age (ORaj=4.4; 95% CI: 2.3–18.3); HIV infection follow-up time of nine years or more (ORaj=4.2; 95% CI: 2.3–7.8)]; number of sexual partners during the entire life between three and five partners (ORaj=2.2; 95% CI: 1.1–4.6), and six or more sexual partners (ORaj=3.9; 95% CI: 1.9–8.0%); being a sex worker (ORaj=1.9; 95% CI: 1.1–3.1).
ConclusionsA high prevalence of a prior history of STDs in the studied population was found. It is essential to find better ways to access HIV infection prevention, so that effective interventions can be more widely implemented.
Keywords:
Sexually transmitted diseases
Women
HIV
Behavior
Full text is only aviable in PDF
References
[1.]
G.A. Dallabetta, A.C. Gerbase, K.K. Holmes.
Problems, solutions, and challenges in syndromic management of sexually transmitted diseases.
Sex Transm Infect, 74 (1998), pp. S1-S11
[2.]
P. Mayaud, D. Mabey.
Approaches to the control of sexually transmitted infections in developing countries: old problems and modern challenges.
Sex Transm Infect, 80 (2004), pp. 174-182
[3.]
W. Ferreira, J. Sardinha, A. Schettini, C. Ferreira, A. Benzaken.
Susceptibilidade de cepas de Neisseria gonorrhoeae aos antibióticos utilizados para o tratamento de uretrites e cervicites gonocócicas em ambulatório de DST de Manaus – Brasil.
J Bras Doenças Sex Transm, 13 (2001), pp. 36-40
[4.]
J.N. Wasserheit.
Epidemiological synergy: interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases.
Sex Transm Dis, 19 (1992), pp. 61-77
[5.]
N. Hutton-Rose, C. Blythe, C. Ogbonna, D. McGrowder.
The prevalence of other sexually transmitted infections in confirmed HIV cases at a referral clinic in Jamaica.
J R Soc Promot Health, 128 (2008), pp. 242-247
[6.]
H.C. Lee, N.Y. Ko, C.M. Chang, S.Y. Liu, W.C. Ko.
Trends in sexually transmitted diseases and risk behaviors among HIV-infected patients at an outpatient clinic in southern Taiwan.
Sex Transm Dis, 37 (2010), pp. 86-93
[7.]
R.H. Gray, M.J. Wawer, R. Brookmeyer, et al.
Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1 discordant couples in Rakai, Uganda.
Lancet, 357 (2001), pp. 1149-1153
[8.]
P.D. Ghys, K. Fransen, M.O. Diallo, et al.
The associations between cervicovaginal HIV shedding, sexually transmitted diseases and immunosuppression in female sex workers in Abidjan, Cote d’Ivoire.
AIDS, 11 (1997), pp. F85-F93
[9.]
Consultation on STD interventions for preventing HIV: what is the evidence? UNAIDS/WHO, ISBN 92-9173-137-4. Geneva, 2000. Available from: http://www.who.int/hiv/pub/sti/who_hsi_2000_02.pdf
[10.]
D. Donnell, J.M. Baeten, J. Kiarie, et al.
Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis.
Lancet, 375 (2010), pp. 2092-2098
[11.]
M.S. Cohen, I.F. Hoffman, R.A. Royce, et al.
Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1.
Lancet, 349 (1997), pp. 1868-1873
[12.]
A.G. Marcelin, R. Tubianar, S. Lambert-Niclot, et al.
Detection of HIV-1 RNA in seminal plasma samples from treated patients with undetectable HIV-RNA in blood plasma.
AIDS, 22 (2008), pp. 1677-1679
[13.]
T.V. Ellerbrock, M.A. Chiasson, T.J. Bush, et al.
Incidence of cervical squamous intraepithelial lesions in HIV-infected women.
JAMA, 283 (2000), pp. 1031-1037
[14.]
J.S. Mandelblatt, M. Fahs, K. Garibaldi, R.T. Senie, H.B. Petersen.
Association between HIV infection and cervical neoplasia: implications for clinical care of women at risk for both conditions.
AIDS, 6 (1992), pp. 173-178
[15.]
J. Palefsky.
Human papillomavirus-related disease in people with HIV.
Curr Opin HIV AIDS, 4 (2009), pp. 52-56
[16.]
R.R. Campos, V.H. Melo, D.M. Castillo, C.P.F. Nogueira.
Prevalência do papilomavirus humano e seus genótipos em mulheres portadoras e não-portadoras do vírus da imunodeficiência humana.
Rev Bras Ginecol Obstet, 27 (2005), pp. 248-256
[17.]
I. Heard.
Cervical disease and cancer in HIV positive women. Recommendations for screening and diagnosis.
Med Wieku Rozwoj, 7 (2003), pp. 479-485
[18.]
Ministério da Saúde (Brasil).
Secretaria de Vigilância em Saúde. Departamento de DST, AIDS e Hepatites virais. Boletim Epidemiológico - AIDS e DST.
Ministério da Saúde, (2009),
[19.]
W.V. Villela, V.M. Pinto.
Atenção às DST em mulheres.
Compromissos do governo brasileiro com a plataforma da conferência internacional sobre população e desenvolvimento: rumos para Cairo +20, Presidência da República. Secretaria Especial de Políticas para as Mulheres, (2010),
[20.]
E.H. Rodrigues, F.G. Abath.
Sexually transmitted diseases in patients infected with HIV/AIDS in the State of Pernambuco.
Brazil. Rev Soc Bras Med Trop, 33 (2000), pp. 47-52
[21.]
A.P.C. Henriques, V. Magalhães, T. Tenório.
Infecções genitais em mulheres infectadas pelo vírus da imunodeficiência humana (HIV) acompanhadas no hospital das clínicas da UFPE.
NewsLab, 72 (2005), pp. 90-102
[22.]
B. Grinsztejn, V.G. Veloso, J.E. Levi, et al.
Factors associated with increased prevalence of human papillomavirus infection in a cohort of HIV-infected Brazilian women.
Int J Infect Dis, 13 (2009), pp. 72-80
[23.]
M.G. Fonseca, F.I. Bastos.
Twenty-five years of the AIDS epidemic in Brazil: principal epidemiological findings, 1980–2005.
Cad Saude Publica, 23 (2007), pp. S333-S344
[24.]
D. Flemming, J. Wasserheit.
From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection.
Sex Transm Inf, 75 (1999), pp. 3-17
[25.]
S.E. Hawes, C.W. Critchlow, M.A. Faye Niang, et al.
Increased risk of high-grade cervical squamous intraepithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections.
J Infect Dis, 188 (2003), pp. 555-563
[26.]
I. Heard, J.M. Tassie, V. Schmitz, L. Mandelbrot, M.D. Kazatchkine, G. Orth.
Increased risk of cervical disease among human immunodeficiency virus infected women with severe immunosuppression and high human papillomavirus load.
Obstet Gynecol, 96 (2000), pp. 403-409
[27.]
S. de Sanjose, I. Valls, M. Paz Cañadas, et al.
Human papillomavirus and human immunodeficiency virus infections as risk factors for cervix cancer in women prisoners.
Med Clin (Barc), 115 (2000), pp. 81-84
[28.]
J. Nyagol, E. Leucci, A. Onnis, et al.
The effects of HIV-1 Tat protein on cell cycle during cervical carcinogenesis.
Cancer Biol Ther, 5 (2006), pp. 684-690
[29.]
P.B. Gichangi, J. Bwayo, B. Estambale, et al.
Impact of HIV infection on invasive cervical cancer in Kenyan women.
AIDS, 17 (2003), pp. 1963-1968
[30.]
B. Clarke, R. Chetty.
Postmodern cancer: the role of human immunodeficiency virus in uterine cervical cancer.
Mol Pathol, 55 (2002), pp. 19-24
[31.]
C. Ng’andwe, J.L. Lowe, P.J. Richards, L. Hause, C. Wood, P.C. Angeletti.
The distribution of sexually transmitted human papillomaviruses in HIV positive and negative patients in Zambia.
Africa. BMC Infect Dis, 7 (2007), pp. 77
[32.]
J. Saxton, R. Malyuta, I. Semeneko, et al.
Previous reproductive history and post-natal family planning among HIV-infected women in Ukraine.
Hum Reprod, 25 (2010), pp. 2366-2373
[33.]
L.J. Abu-Raddad, A.S. Magaret, C. Celum, et al.
Genital herpes has played a more important role than any other sexually transmitted infection in driving HIV prevalence in Africa.
PLoS ONE, 3 (2008), pp. e2230
[34.]
E.M. Jalil, V.M. Pinto, A.S. Benzaken, et al.
Prevalência da infecção por clamídia e gonococo em gestantes de seis cidades brasileiras.
Rev Bras Ginecol Obstet, 30 (2008), pp. 614-619
[35.]
V.M. Pinto, C.L. Szwarcwald, C. Baroni, L.L. Stringari, L.A. Inocêncio, A.E. Miranda.
Chlamydia trachomatis prevalence and risk behaviors in parturient women aged 15 to 24 in Brazil.
Sex Transm Dis, 38 (2011), pp. 957-961
Copyright © 2012. Elsevier Editora Ltda.. All rights reserved
