HIV Status and Other Risk Factors for Prevalent and Incident Sexually Transmitted Infection during Pregnancy (2000-2014).
Adult
Alabama
/ epidemiology
Chlamydia Infections
/ epidemiology
Cohort Studies
Female
Gonorrhea
/ epidemiology
HIV Infections
/ complications
Humans
Incidence
Pregnancy
Pregnancy Complications, Infectious
/ epidemiology
Prevalence
Retrospective Studies
Risk Factors
Sexually Transmitted Diseases
/ epidemiology
Syphilis
/ epidemiology
Trichomonas Infections
/ epidemiology
Journal
Infectious diseases in obstetrics and gynecology
ISSN: 1098-0997
Titre abrégé: Infect Dis Obstet Gynecol
Pays: Egypt
ID NLM: 9318481
Informations de publication
Date de publication:
2019
2019
Historique:
received:
15
11
2018
revised:
28
02
2019
accepted:
14
03
2019
entrez:
7
5
2019
pubmed:
7
5
2019
medline:
10
7
2019
Statut:
epublish
Résumé
Sexually transmitted infections (STIs) are associated with adverse birth outcomes. Current prenatal STI screening guidelines define "risk" without explicit consideration of HIV status. Our objective was to test the hypothesis that HIV status is associated with bacterial STI in pregnant women. We designed a retrospective cohort study to identify pregnant women with HIV who delivered at our facility during 2000-2014. HIV+ women were compared to HIV- women with matching by year of delivery. Logistic regression was used to model adjusted odds of prevalent and incident STI. Prevalent STI was defined as chlamydia (CT), gonorrhea (GC), syphilis, or trichomoniasis detected on an initial prenatal screening test and incident STI as a newly positive result following a negative prenatal test. The cohort included 432 women, 210 HIV+ and 222 HIV-. Most pregnant women were screened for STI (92% of HIV+ women and 74% of HIV- women). STI rates were high and particularly elevated in HIV+ women: 29% vs 18% (p=0.02), for prevalent STI and 11% vs 2% (p<0.001) for incident STI. Risk factors for prevalent STI were as follows: HIV status (aOR 3.0, CI: 1.4-6.4), Black race (aOR 2.7, 95% CI: 1.1-6.6), and more recent delivery (2007-2014 compared to 2000-2006) (aOR 2.3, CI: 1.1-4.7). HIV status was an independent risk factor for incident STI (aOR 7.2, CI: 2.1-25.0). Pregnant women who delivered in our center had high STI rates. Since HIV infection was independently associated with prevalent and incident STI, prenatal screening guidelines may need to incorporate HIV status as a high-risk group for repeat testing.
Sections du résumé
Background
Sexually transmitted infections (STIs) are associated with adverse birth outcomes. Current prenatal STI screening guidelines define "risk" without explicit consideration of HIV status. Our objective was to test the hypothesis that HIV status is associated with bacterial STI in pregnant women.
Methods
We designed a retrospective cohort study to identify pregnant women with HIV who delivered at our facility during 2000-2014. HIV+ women were compared to HIV- women with matching by year of delivery. Logistic regression was used to model adjusted odds of prevalent and incident STI. Prevalent STI was defined as chlamydia (CT), gonorrhea (GC), syphilis, or trichomoniasis detected on an initial prenatal screening test and incident STI as a newly positive result following a negative prenatal test.
Results
The cohort included 432 women, 210 HIV+ and 222 HIV-. Most pregnant women were screened for STI (92% of HIV+ women and 74% of HIV- women). STI rates were high and particularly elevated in HIV+ women: 29% vs 18% (p=0.02), for prevalent STI and 11% vs 2% (p<0.001) for incident STI. Risk factors for prevalent STI were as follows: HIV status (aOR 3.0, CI: 1.4-6.4), Black race (aOR 2.7, 95% CI: 1.1-6.6), and more recent delivery (2007-2014 compared to 2000-2006) (aOR 2.3, CI: 1.1-4.7). HIV status was an independent risk factor for incident STI (aOR 7.2, CI: 2.1-25.0).
Conclusion
Pregnant women who delivered in our center had high STI rates. Since HIV infection was independently associated with prevalent and incident STI, prenatal screening guidelines may need to incorporate HIV status as a high-risk group for repeat testing.
Identifiants
pubmed: 31057323
doi: 10.1155/2019/6584101
pmc: PMC6463595
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
6584101Subventions
Organisme : NICHD NIH HHS
ID : K23 HD090993
Pays : United States
Références
PLoS One. 2018 Jan 5;13(1):e0189851
pubmed: 29304083
AIDS Res Hum Retroviruses. 2015 Nov;31(11):1153-9
pubmed: 26061218
MMWR Morb Mortal Wkly Rep. 2019 Feb 15;68(6):144-148
pubmed: 30763294
MMWR Morb Mortal Wkly Rep. 2018 Jul 20;67(28):778-781
pubmed: 30024864
N Engl J Med. 2014 Jun 5;370(23):2211-8
pubmed: 24897084
Clin Infect Dis. 2015 Jul 15;61(2):260-9
pubmed: 25900168
Pediatr Infect Dis J. 2017 Jan;36(1):66-71
pubmed: 27749662
AIDS. 2015 Sep 24;29(15):2025-33
pubmed: 26352880
Am Fam Physician. 2016 Dec 1;94(11):907-915
pubmed: 27929270
Sex Transm Dis. 2018 May;45(5):301-306
pubmed: 29485542
Infect Dis Obstet Gynecol. 2016;2016:8048457
pubmed: 27313441
J Subst Use. 2017;22(1):90-95
pubmed: 29515331
J Acquir Immune Defic Syndr. 2014 Jun 1;66(2):109-17
pubmed: 24413042
AIDS. 2015 Jan 2;29(1):117-23
pubmed: 25562496
JAMA. 1986 Oct 10;256(14):1899-903
pubmed: 3761496
Sex Transm Dis. 2007 Dec;34(12):991-4
pubmed: 18080350
J Infect Dis. 2018 Jun 5;218(1):16-25
pubmed: 29514254
Ann Intern Med. 2009 May 19;150(10):710-6
pubmed: 19451578
Pediatr Infect Dis J. 2015 Mar;34(3):e52-7
pubmed: 25742089
Sex Transm Dis. 2011 Mar;38(3):167-71
pubmed: 20852454
MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137
pubmed: 26042815
Sex Transm Dis. 2017 May;44(5):266-271
pubmed: 28407641
Lancet. 2017 Nov 4;390(10107):2036
pubmed: 29115242
PLoS Med. 2014 Feb 25;11(2):e1001608
pubmed: 24586123
Sex Transm Dis. 2015 Oct;42(10):554-65
pubmed: 26372927
Obstet Gynecol. 2015 May;125(5):1211-6
pubmed: 25932850
AIDS. 2011 Sep 24;25(15):1887-95
pubmed: 21785321
N Engl J Med. 2018 Apr 26;378(17):1593-1603
pubmed: 29694825
Obstet Gynecol. 2018 Sep;132(3):708-716
pubmed: 30095786
Matern Child Health J. 2018 Apr;22(4):538-545
pubmed: 29417361