title: Prevalence and Correlates of Genital Infections Among Newly Diagnosed Human Immunodeficiency Virus-Infected Adults Entering Human Immunodeficiency Virus Care in Windhoek, Namibia.
abstract: Identifying and treating genital infections, including sexually transmitted infections (STI), among newly diagnosed human immunodeficiency virus (HIV)-infected individuals may benefit both public and individual health. We assessed prevalence of genital infections and their correlates among newly diagnosed HIV-infected individuals enrolling in HIV care services in Namibia.
  
  
  
  Newly diagnosed HIV-infected adults entering HIV care at 2 health facilities in Windhoek, Namibia, were recruited from December 2012 to March 2014. Participants provided behavioral and clinical data including CD4+ T lymphocyte counts. Genital and blood specimens were tested for gonorrhea, Chlamydia, trichomoniasis, Mycoplasma genitalium, syphilis, bacterial vaginosis, and vulvovaginal candidiasis.
  
  
  
  Among 599 adults, 56% were women and 15% reported consistent use of condoms in the past 6 months. The most common infections were bacterial vaginosis (37.2%), trichomoniasis (34.6%) and Chlamydia (14.6%) in women and M. genitalium (11.4%) in men. Correlates for trichomoniasis included being female (adjusted relative risk, [aRR], 7.18; 95% confidence interval [CI], 4.07-12.65), higher education (aRR, 0.58; 95% CI, 0.38-0.89), and lower CD4 cell count (aRR, 1.61; 95% CI, 1.08-2.40). Being female (aRR, 2.39; 95% CI, 1.27-4.50), nonmarried (aRR, 2.30; (95% CI, 1.28-4.14), and having condomless sex (aRR, 2.72; 95% CI, 1.06-7.00) were independently associated with chlamydial infection. Across all infections, female (aRR, 2.31; 95% CI, 1.79-2.98), nonmarried participants (aRR, 1.29; 95% CI, 1.06-1.59), had higher risk to present with any STI, whereas pregnant women (aRR, 1.16, 95% CI 1.03-1.31) were at increased risk of any STI or reproductive tract infection.
authors.affiliation: From the *US Centers for Disease Control and Prevention, Atlanta, GA; †ASPPH/CDC Allan Rosenfield Global Health Fellow, US Centers for Disease Control and Prevention; ‡Ministry of Health and Social Services, Republic of Namibia; §Namibian Institute of Pathology; and ∥US Centers for Disease Control and Prevention, Windhoek, Namibia.
authors.forename: Gaston
authors.initials: G
authors.lastname: Djomand
authors.forename: Madeleine
authors.initials: M
authors.lastname: Schlefer
authors.forename: Steve
authors.initials: S
authors.lastname: Gutreuter
authors.forename: Sarah
authors.initials: S
authors.lastname: Tobias
authors.forename: Roopal
authors.initials: R
authors.lastname: Patel
authors.forename: Nickolas
authors.initials: N
authors.lastname: DeLuca
authors.forename: Julia
authors.initials: J
authors.lastname: Hood
authors.forename: Souleymane
authors.initials: S
authors.lastname: Sawadogo
authors.forename: Cheng
authors.initials: C
authors.lastname: Chen
authors.forename: Alexinah
authors.initials: A
authors.lastname: Muadinohamba
authors.forename: David W
authors.initials: DW
authors.lastname: Lowrance
authors.forename: Naomi
authors.initials: N
authors.lastname: Bock
mesh_terms: D000328:Adult; D060085:Coinfection; D017280:Condoms; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications / Q000453:epidemiology*; D005832:Genital Diseases, Male / Q000150:complications / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D009276:Namibia / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology*