STI prevalence, incidence, and partner notification among women in a periconception HIV prevention program in Uganda

Author:

Chitneni Pooja123ORCID,Muyindike Winnie4,Bwana Mwebesa Bosco4,Owembabazi Moran4,O’Neil Kasey15,Kalyebara Paul Kato4,Hedt-Gauthier Bethany6,Bangsberg David R7,Marrazzo Jeanne M8,Kaida Angela9,Haberer Jessica E3410,Matthews Lynn T8

Affiliation:

1. Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA

2. Division of Infectious Diseases and General Internal Medicine, Brigham and Women’s Hospital, Boston, MA, USA

3. Harvard Medical School, Boston, MA, USA

4. Mbarara Regional Referral Hospital and Mbarara University of Science and Technology, Mbarara, Uganda

5. Mbarara University of Science and Technology Global Health Collaborative, Mbarara, Uganda

6. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA

7. OHSU PSU School of Public Health, Portland, OR, USA

8. Division of Infectious Diseases, University of Alabama, Birmingham, AL, USA

9. Simon Fraser University, Burnaby, British Columbia, Canada

10. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA

Abstract

Background We provided sexually transmitted infection (STI) screening and facilitated partner notification and treatment among women participating in a periconception HIV prevention program in southwestern Uganda to understand follow-up STI incidence. Methods Women at-risk for HIV exposure while planning for pregnancy completed laboratory screening for chlamydia, gonorrhea, trichomoniasis, and syphilis at enrollment and 6 months of follow-up and/or incident pregnancy; facilitated partner notification and treatment were offered for those with positive tests. We performed a logistic regression to determine correlates of follow-up STI. Results Ninety-four participants completed enrollment STI screening with a median age of 29 (IQR 26–34); 23 (24%) had ≥1 STI. Of the 23 participants with enrollment STI(s), all completed treatment and 19 (83%) returned for follow-up; 18 (78%) reported delivering partner notification cards and discussing STIs with partner(s), and 14 (61%) reported all partners received STI treatment. Of the 81 (86%) who successfully completed follow-up STI screening, 17 (21%) had ≥1 STI. The STI incidence rate was 29.0 per 100 person-years. In univariable regression analysis, enrollment STI, younger age, less education, and alcohol consumption were all significantly associated with follow-up STI. Conclusions We demonstrated high enrollment and follow-up STI rates and moderate participant-reported partner treatment among women planning for pregnancy in Uganda despite partner notification and treatment. Novel STI partner notification and treatment interventions are needed to decrease the STI burden, especially among women planning for and with pregnancy.

Funder

Doris Duke Charitable Foundation

National Institute of Health

Fogarty International Center

Division of Intramural Research, National Institute of Allergy and Infectious Diseases

Publisher

SAGE Publications

Subject

Infectious Diseases,Pharmacology (medical),Public Health, Environmental and Occupational Health,Dermatology

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