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      Sexual risk behaviour in a cohort of HIV-negative and HIV-positive Rwandan women

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          Abstract

          Here we wanted to assess whether sexual risk behaviour differs dependent by human immunodeficiency virus (HIV) status by following 100 HIV− and 137 HIV+ women recruited at two university teaching hospitals in Rwanda. Women were tested for sexually transmitted infections (STIs; trichomoniasis, syphilis, hepatitis B and C) and for reproductive tract infections (RTIs; candidiasis, bacterial vaginosis (BV)) and were interviewed at baseline and 9 months later. BV was the most prevalent infection, while syphilis was the most common STI with a 9-month incidence of 10.9% in HIV+ women. Only 24.5% of women positive for any RTI/STI contacted their health facility and got treatment. More HIV− women than HIV+ women had had more than one sexual partner and never used condoms during the follow-up period. The use of condoms was affected neither by marital status nor by concomitant STIs besides HIV. Our data highlight the importance of public education regarding condom use to protect against STIs in an era when HIV no longer is a death sentence.

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          Contribution of sexually transmitted infections to the sexual transmission of HIV.

          Helen Ward, Minttu Rönn (2010)
          We review recent evidence about the link between sexually transmitted infections (STI) and HIV transmission and consider implications for control programmes. New studies and meta-analyses confirm the association of HIV acquisition and transmission with recent STIs, although there is considerable heterogeneity between organisms and populations. Much of the recent evidence relates to herpes simplex virus type 2 (HSV-2), for which the population-attributable risk percentage (PAR%) for HSV-2 is between 25 and 35 in Africa. Mathematical models show how transmission attributable to STI varies with HIV epidemic phase, and HSV-2 becomes increasingly important as the epidemic matures. HSV-2 suppressive therapy reduces HIV concentrations in plasma and the genital tract in people coinfected with HSV-2, in part due to direct inhibition of HIV reverse transcriptase. Recent trials of HSV-2 suppressive therapy have not shown an impact on the risk of HIV acquisition, nor in controlling transmission from dually infected people to their serodiscordant heterosexual partners. Although there is a plausible link between STI and HIV risk, intervention studies continue to be disappointing. This fact does not disprove a causal link, but mechanisms of action and the design and implementation of interventions need to be better understood.
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            Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985-1997.

            K. L. Bickham, Lance Weinhardt, Leeanne M. Carey … (1999)
            This study examined whether HIV counseling and testing leads to reductions in sexual risk behavior. The meta-analysis included 27 published studies that provided sexual behavior outcome data, assessed behavior before and after counseling and testing, and provided details sufficient for the calculation of effect sizes. The studies involved 19,597 participants. After counseling and testing, HIV-positive participants and HIV-serodiscordant couples reduced unprotected intercourse and increased condom use more than HIV-negative and untested participants. HIV-negative participants did not modify their behavior more than untested participants. Participants' age, volition for testing, and injection drug use treatment status, as well as the sample seroprevalence and length of the follow-up, explained the variance in results. HIV counseling and testing appears to provide an effective means of secondary prevention for HIV-positive individuals but, as conducted in the reviewed studies, is not an effective primary prevention strategy for uninfected participants. Theory-driven research with attention given to the context of testing is needed to further explicate the determinants of behavior change resulting from HIV counseling and testing, and the effectiveness of specific counseling approaches.
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              Homogeneous amplification of genital human alpha papillomaviruses by PCR using novel broad-spectrum GP5+ and GP6+ primers.

              Markus Schmitt, Bolormaa Dondog, Tim Waterboer … (2008)
              Human papillomavirus (HPV) DNA detection and typing are important for diagnosis and management of HPV-associated diseases. One of the most commonly used PCR methods, GP5+/6+, shows weaknesses in amplifying certain types. To circumvent this limitation, we developed and validated broad-spectrum primers targeting the GP5+/6+ region. The addition of eight upstream and two downstream BSGP5+/6+ (BS) primers improved amplification of plasmids of 14 genital HPV types 10- to 1,000-fold versus GP5+/6+ PCR without altering sensitivity for the 10 others. For these 24 types, an analytic sensitivity of < or = 1,000 plasmid copies in the presence of 100 ng cellular DNA was obtained. Additionally, we integrated an internal beta-globin PCR into both HPV PCR systems, allowing simultaneous DNA quality control without affecting the sensitivity of HPV detection. Furthermore, we describe five additional low-risk HPV probes used in multiplex HPV genotyping (MPG) for simultaneous identification of all 15 high-risk, 3 putative high-risk, and 9 low-risk HPV genotypes. The performance of BSGP5+/6+ multiplexed with beta-globin primers was compared to that of standard GP5+/6+ with DNA from 1,112 cervical scrapings. There was 79% overall agreement (kappa = 0.816). BSGP5+/6+ was significantly more sensitive than GP5+/6+ for detection of HPV 30, 39, 42, 44, 51, 52, 53, 68, 73, and 82, detecting 212 additional HPV infections and increasing the proportion of multiple infections from 17.2 to 26.9% in cancer patients. In conclusion, BSGP5+/6+ multiplexed with beta-globin PCR provides an improvement in type-specific amplification sensitivity and homogeneity compared to GP5+/6+ and offers simultaneous internal control of DNA quality. BSGP5+/6+-MPG, therefore, is suitable for epidemiologic and also diagnostic applications.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Epidemiol Infect
                Journal ID (iso-abbrev): Epidemiol. Infect
                Journal ID (publisher-id): HYG
                Title: Epidemiology and Infection
                Publisher: Cambridge University Press (Cambridge, UK )
                ISSN (Print): 0950-2688
                ISSN (Electronic): 1469-4409
                Publication date Collection: 2019
                Publication date (Electronic): 3 December 2018
                Volume: 147
                Electronic Location Identifier: e54
                Affiliations
                [1 ]Department of Pharmacology, University of Gothenburg , Gothenburg, Sweden
                [2 ]College of Medicine and Health Sciences, University of Rwanda , Kigali, Rwanda
                [3 ]University Teaching Hospital of Kigali (CHUK) , Kigali, Rwanda
                [4 ]Department of Oncology, University of Gothenburg , Gothenburg, Sweden
                Author notes
                Author for correspondence: D. Giglio, E-mail: daniel.giglio@ 123456pharm.gu.se
                Author information
                https://orcid.org/0000-0002-1349-9336
                Article
                Publisher Item ID: S0950268818003023 Publisher ID: 00302
                DOI: 10.1017/S0950268818003023
                PMC ID: 6518557
                PubMed ID: 30501649
                SO-VID: 58635f24-7a8a-4a79-a0f7-aed8ce36dbfa
                Copyright © © The Author(s) 2018
                License:

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 May 2018
                Date revision received : 28 August 2018
                Date accepted : 10 October 2018
                Page count
                Figures: 2, Tables: 3, References: 41, Pages: 9
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Public health
                Keywords: candida,gonorrhoea,hiv/aids,infectious disease epidemiology,sexually transmitted infections (stis)
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: candida, gonorrhoea, hiv/aids, infectious disease epidemiology, sexually transmitted infections (stis)

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