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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Prevalence and incidence of sexually transmitted infections among South African women initiating injectable and long-acting contraceptives
PLoS ONE, Volume 18, No. 11 November, Article e0294285, Year 2023
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Description
Background South Africa is among the countries with the highest prevalence of sexually transmitted infections (STIs), including Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). In 2017, there were an estimated 6 million new CT, 4.5 million NG and 71 000 Treponema pallidum infections among South African men and women of reproductive age. Methods We evaluated STI prevalence and incidence and associated risk factors in 162 women aged 18–33 years old, residing in eThekwini and Tshwane, South Africa who were part of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial. Women were randomised to use depot medroxyprogesterone acetate (n = 53), copper intrauterine device (n = 51), or levonorgestrel (n = 58) implant. Lateral vaginal wall swab samples were collected prior to contraceptive initiation and at months one and three following contraceptive initiation for STI testing. Results There were no significant differences in STI incidence and prevalence across contraceptive groups. At baseline, 40% had active STIs (CT, NG, Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) or herpes simplex virus-2 shedding across all age groups–18–21 years (46%), 22–25 years (42%) and 26–33 years (29%). The incidence of STIs during follow-up was exceptionally high (107.9/100 women-years [wy]), with younger women (18–21 years) more likely to acquire CT (75.9/100 wy) compared to 26–33 year olds (17.4/ 100 wy; p = 0.049). TV incidence was higher in the 26–33 year old group (82.7/100 wy) compared to the 18–21 year olds (8.4/100 wy; p = 0.01). Conclusions Although the study participants received extensive counselling on the importance of condom use, this study highlights the high prevalence and incidence of STIs in South African women, especially amongst young women, emphasising the need for better STI screening and management strategies. © 2023 Harryparsad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Authors & Co-Authors
Harryparsad, Rushil
South Africa, Cape Town
University of Cape Town
Meyer, Bahiah
South Africa, Cape Town
University of Cape Town
Taku, Ongeziwe
South Africa, Cape Town
University of Cape Town
Serrano, Myrna G.
United States, Richmond
Virginia Commonwealth University
Chen, Pai Lien
United States, Durham
Fhi 360
Gao, Xiaoming
United States, Durham
Fhi 360
Williamson, Anna Lise
South Africa, Cape Town
University of Cape Town
Mehou-Loko, Celia
South Africa, Cape Town
University of Cape Town
d’Hellencourt, Florence Carayon Lefebvre
United States, Durham
Fhi 360
Smit, Jennifer Ann
South Africa, Johannesburg
University of the Witwatersrand
Strauss, Jerome F.Iii
United States, Philadelphia
University of Pennsylvania
Nanda, Kavita
United States, Durham
Fhi 360
Ahmed, Khatija
South Africa, Pretoria
Setshaba Research Centre
South Africa, Pretoria
University of Pretoria
Beksinska, Mags E.
South Africa, Johannesburg
University of the Witwatersrand
Buck, Gregory A.
United States, Richmond
Virginia Commonwealth University
Morrison, Charles S.
United States, Durham
Fhi 360
Deese, Jennifer
United States, New York
Pfizer Inc.
Masson, Lindi
South Africa, Cape Town
University of Cape Town
Australia, Melbourne
Burnet Institute
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Australia, Clayton
Monash University
Statistics
Authors: 18
Affiliations: 11
Identifiers
Doi:
10.1371/journal.pone.0294285
ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa
Participants Gender
Male
Female