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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effect of trichomoniasis therapy on genital HIV viral burden among African women
Sexually Transmitted Diseases, Volume 39, No. 8, Year 2012
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Description
BACKGROUND: Our objective was to test the hypothesis that treatment for trichomoniasis among HIV-infected women not taking antiretrovirals in South Africa would be associated with decreased HIV genital shedding. METHODS: HIV-infected women presenting for routine HIV care were screened for trichomoniasis using self-collected vaginal swabs with a rapid point-of-care immunochromatographic antigen test. Women testing positive were offered enrollment into a prospective cohort study, if they had documented HIV infection, were aged 18 to 50 years, and were not receiving antiretroviral therapy. Recent use of postexposure prophylaxis or antibiotic therapy, active genital ulcers, or systemic illness were exclusion criteria. Cervical swabs were collected for gonococcal and chlamydial testing, and those testing positive were excluded. Women were treated with directly observed oral therapy with 2 g of oral metronidazole. A follow-up visit was scheduled 1 month after therapy, and partner letters were provided. Paired cervical wicks and plasma were collected for viral load measurement. RESULTS: In all, 557 women were screened. Sixty tested positive for trichomoniasis, 10 subsequently met exclusion criteria, and 4 were lost to follow-up. Of 46 women evaluated at follow-up, 37 (80.4%) were cured. Plasma viral load was not significantly different after therapy (P = 0.93). Genital tract viral load decreased by 0.5 log10 (P < 0.01). The mean genital tract viral load (log10) decreased from 4.66 (<3.52-6.46) to 4.18 (<3.52-6.48) (P < 0.01) after therapy. CONCLUSIONS: Screening and treatment of vaginal trichomoniasis decrease genital shedding of HIV among South African women not receiving antiretrovirals at 1 month after therapy. Copyright © 2012 American Sexually Transmitted Diseases Association.
Authors & Co-Authors
Anderson, Brenna L.
United States, Providence
The Warren Alpert Medical School
Firnhaber, Cynthia S.
South Africa, Johannesburg
University of the Witwatersrand
South Africa, Johannesburg
Right to Care
Liu, Tao
United States, Providence
Brown University
Swarts, Avril J.
South Africa, Johannesburg
University of the Witwatersrand
Siminya, Maureen
South Africa, Johannesburg
Right to Care
Ingersoll, Jessica
United States, Atlanta
Emory University School of Medicine
Caliendo, Angela M.
United States, Atlanta
Emory University School of Medicine
Cu-Uvin, Susan
United States, Providence
The Warren Alpert Medical School
Statistics
Citations: 41
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1097/OLQ.0b013e31825725ad
ISSN:
01485717
e-ISSN:
15374521
Research Areas
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female