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Title
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Incidence rate of sexually transmitted infections among HIV infected patients on long-term ART in an urban and a rural clinic in Uganda
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Author
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Abstract
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| BackgroundHIV immunosuppression increases susceptibility to other STIs and STIs can enhance HIV transmission, reduce CD4 cell count and increase viral load. Co-infections of HIV and STIs may thus reduce the preventive benefits of ART. Little is known about the incidence rate of STIs among long-term patients on ART.MethodWe conducted a secondary data analysis of all patients enrolled in a rural and an urban longitudinal cohort studies who initiated ART between April 2003 and July 2007 followed up to 2016. Patients were screened for STI every three months using a syndromic and case management approaches. STI incidence rate, was defined as the number of new cases per population at risk over the follow-up review period. We performed a time-to-event and Kaplan Meier analysis. We used a multivariable Cox proportional hazards regression model to assess for factors associated with STI incidence.ResultOf 1012 participants, 402 (39.8%) were urban and 610 (60.2%) rural residents. Mean age was 42.8years (SD 8.5). The total number of follow up time was 44,304 person years. We observed STI incidence rate of 2.1 per 1000 person-years after follow-up. Rural residence (adjusted hazard ratio [aHR] 3.53, 95% CI: 1.95-6.39), younger age (aHR 2.05, 95% CI: 1.02-4.12 for 18-34years and aHR 1.65, 95% CI: 1.00-2.72 for 35-44years) were factors associated with higher incidence of STIs. Being male (aHR 0.51, 95% CI: 0.27-0.93) was associated with a lower incidence of STIs.ConclusionWe found STIs incidence rate of approximately 3 per 1000 person-years among patients on long-term ( 4years) ART followed up-to 3.5years. Rural and younger persons on ART should be routinely screened for STIs because high incidence of STIs may undo the preventative effects of ART for all. |
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Language
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English
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Source (journal)
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BMC public health. - London
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Publication
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London
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2019
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ISSN
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1471-2458
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DOI
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10.1186/S12889-019-6417-X
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Volume/pages
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19
(2019)
, 8 p.
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Article Reference
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87
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ISI
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000456168400003
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Pubmed ID
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30658611
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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