title: Risk factors for sexually transmitted infections in women in rural Northeast Brazil.
abstract: BACKGROUND
  Sexually transmitted infections (STIs) are highly prevalent in northeast Brazil, but factors associated with the presence of an STI have rarely been studied systematically.
  
  
  METHODS
  We performed a population-based study to assess factors associated with STIs in women of reproductive age (12 to 49 years) in a rural setting in northeast Brazil. A total of 734 women were eligible; 592 (80.7%) had initiated sexual life and were included. Women were examined for the presence of an STI. Socio-economic variables, sexual history, and behaviour were assessed through a structured questionnaire. Laboratory testing included: polymerase chain reaction for human papillomavirus (HPV); ligase chain reaction for Chlamydia trachomatis and Neisseria gonorrhoeae; VDRL and FTA-ABS for Treponema pallidum; analysis of wet mounts, gram stain and Pap smears for Trichomonas vaginalis; and ELISA for HIV.
  
  
  RESULTS
  At least one STI was present in 112 (19.6%) of the women. In logistic regression analysis, a previous visit to a Pap smear clinic was protective against an STI (OR=0.26; IC 95%: 0.12-0.57). The following variables were independently associated with STIs: > or =3 partners in life (2.35; 1.32-4.17); first pregnancy < 16 years of age (2.28; 1.09-4.78); not knowing if partner had another partner (3.56; 1.09-11.62).
  
  
  CONCLUSIONS
  The protective and risk factors identified can guide the implementation of gender- and age-specific control programs in rural northeast Brazil. Offering a simple preventive measure (Pap smear collection), usually done by a nurse in this setting, may be a useful opportunity for diagnosis and treatment of curable STIs, without considerable additional costs.
authors.affiliation: Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil. foliveira@web.de
authors.forename: Fabíola Araújo
authors.initials: FA
authors.lastname: Oliveira
authors.forename: Katrin
authors.initials: K
authors.lastname: Lang
authors.forename: Viola
authors.initials: V
authors.lastname: Ehrig
authors.forename: Jorg
authors.initials: J
authors.lastname: Heukelbach
authors.forename: Francisco
authors.initials: F
authors.lastname: Fraga
authors.forename: Marina
authors.initials: M
authors.lastname: Stoffler-Meilicke
authors.forename: Ralf
authors.initials: R
authors.lastname: Ignatius
authors.forename: Ligia Regina
authors.initials: LR
authors.lastname: Franco Sansigolo Kerr
authors.forename: Hermann
authors.initials: H
authors.lastname: Feldmeier
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D011247:Pregnancy; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014210:Treponema pallidum / Q000302:isolation & purification; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014626:Vaginal Smears