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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women
Journal of Acquired Immune Deficiency Syndromes, Volume 48, No. 2, Year 2008
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Description
OBJECTIVE:: To evaluate interrelationships between bacterial vaginosis (BV), vaginal yeast, vaginal practices (cleansing and drying/tightening), mucosal inflammation, and HIV acquisition. METHODS:: A multicenter, prospective, observational cohort study was conducted, enrolling 4531 HIV-negative women aged 18 to 35 years attending family planning clinics in Zimbabwe and Uganda. Participants were tested for HIV and reproductive tract infections and were interviewed about vaginal practices every 3 months for 15 to 24 months. BV was measured by Gram stain Nugent scoring, vaginal yeast by wet mount, and mucosal inflammation by white blood cells on Gram stain. RESULTS:: HIV incidence was 4.12 and 1.53 per 100 woman-years of follow-up in Zimbabwe and Uganda, respectively (a total of 213 incident infections). Women with BV or vaginal yeast were more likely to acquire HIV, especially if the condition was present at the same visit as the new HIV infection and the visit preceding it (hazard ratio [HR] = 2.50, 95% confidence interval [CI]: 1.68 to 3.72 and HR = 2.97, 95% CI: 1.67 to 5.28 for BV and yeast, respectively). These relationships did not seem to be mediated by mucosal inflammation. Vaginal drying/tightening was associated with HIV acquisition in univariate (HR = 1.49, 95% CI: 1.03 to 2.15) but not multivariate models. Vaginal cleansing was not associated with HIV acquisition. CONCLUSIONS:: BV and yeast may contribute more to the HIV epidemic than previously thought. Copyright © 2008 by Lippincott Williams & Wilkins.
Authors & Co-Authors
van de Wijgert, Janneke H.H.M.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Morrison, Charles S.
United States, Durham
Fhi 360
Cornelisse, Peter
United States, Seattle
Fred Hutchinson Cancer Research Center
Switzerland, Geneva
Merck Serono International S.a.
Munjoma, Marshall Wesley
Zimbabwe, Harare
University of Zimbabwe
Moncada, Jeanne V.
United States, San Francisco
University of California, San Francisco
Awio, Peter
Uganda, Kampala
Joint Clinical Research Center Uganda
Wang, Jing
United States, Seattle
Fred Hutchinson Cancer Research Center
van der Pol, Barbara J.
United States, Indianapolis
Indiana University School of Medicine
Chipato, Tsungai
Zimbabwe, Harare
University of Zimbabwe
Salata, Robert A.
United States, Cleveland
Case Western Reserve University
Padian, Nancy S.
United States, San Francisco
University of California, San Francisco
Statistics
Citations: 139
Authors: 11
Affiliations: 9
Identifiers
Doi:
10.1097/QAI.0b013e3181743936
ISSN:
15254135
Research Areas
Environmental
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda
Zimbabwe
Participants Gender
Female