title: Neisseria gonorrhoeae and Chlamydia trachomatis infection in HIV-1-infected women taking antiretroviral therapy: a prospective cohort study from Burkina Faso.
abstract: OBJECTIVE
  Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are common sexually transmitted infections (STI). We assessed the cumulative risk of NG and CT in a cohort of HIV-1-infected high-risk women taking antiretrovirals over 4 years in Burkina Faso.
  
  
  METHODS
  Between March 2007 and February 2011, participants were followed every 3-6 months. At each visit, participants underwent a gynaecological examination with collection of cervical and vaginal swabs. Random-effects logistic regression models were used to analyse associations of NG and CT infection with behavioural and biological factors.
  
  
  RESULTS
  172 women had samples tested for NG and CT during the study period, in a total of 1135 visits. NG was detected in 6.4% of women (11/172, 95% CI 2.7 to 10.1) at a rate of 2.76 cases (95% CI 1.53 to 4.99) per 100 person-years. CT was detected in 1.7% (3/172, 95% CI 0 to 3.7) of women at a rate of 0.75 cases (95% CI 0.24 to 2.34) per 100 person-years. The majority of women were asymptomatic (9/14). In the multivariable model, the presence of NG or CT was associated with tobacco use (aOR=11.85, 95% CI 1.13 to 124.17), and concurrent genital HIV-1 RNA shedding (aOR=4.78, 95% CI 1.17 to 19.46). Higher levels of education (aOR=0.17, 95% CI 0.03 to 0.92), and age greater than 35 years (aOR=0.07, 95% CI 0.01 to 0.92) were associated with lower odds of infection.
  
  
  CONCLUSIONS
  The risk of NG or CT infection remains low among high-risk women in Bobo-Dioulasso. This provides some evidence that antiretroviral use does not contribute to behavioural disinhibition. The asymptomatic nature of most infections underscores the need for regular screening and treatment of STIs in core groups.
authors: Department of Clinical Research, London School of Hygiene and Tropical Medicine, , London, UK.
authors: Andrea J
authors: AJ
authors: Low
authors: Issouf
authors: I
authors: Konate
authors: Nicolas
authors: N
authors: Nagot
authors: Helen A
authors: HA
authors: Weiss
authors: David
authors: D
authors: Mabey
authors: Michel
authors: M
authors: Segondy
authors: Peter
authors: P
authors: Vickerman
authors: Nicolas
authors: N
authors: Meda
authors: Philippe
authors: P
authors: van de Perre
authors: Philippe
authors: P
authors: Mayaud
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002050:Burkina Faso / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D015331:Cohort Studies; D060085:Coinfection; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D020380:Needs Assessment; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018571:Sentinel Surveillance; D012725:Sexual Behavior
chemical_list: D019380:Anti-HIV Agents
keywords: Africa; Anteretroviral Therapy; Chlamydia Infection; Gonorrhoea; HIV