Dataset Information

Risk-based screening to identify reproductive tract infection among HIV-infected women desiring use of intrauterine contraceptives.

ABSTRACT:

Background

Reproductive tract infections (RTIs) are a major cause of morbidity and mortality, yet RTI testing remains limited in resource-constrained settings. We assessed performance of an existing RTI risk assessment screening tool among women living with HIV (WLHIV) considering intrauterine contraceptive (IUC) use.

Methods

We conducted a cross-sectional analysis among WLHIV screened for participation in an IUC trial in Cape Town, South Africa (NCT01721798). RTI testing included Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and bacterial vaginosis. Tool scoring was based on five separately scored criteria: (1) age under 25 years, (2) cohabitation with a partner, (3) secondary education, (4) self-reported intermenstrual bleeding and (5) number of current sexual partners and condom use frequency (score 0-5). We assessed tool performance in detecting RTI at 0 vs 1-5, 0-1 vs 2-5 and 0-2 vs 3-5 score thresholds.

Results

Of 303 women, 52% (n=157) reported antiretroviral therapy use and median age was 31 years. The prevalence of any RTI was 38% (gonorrhoea=7%, chlamydia=11%, trichomoniasis=12% and bacterial vaginosis=18%) and 8% of women had multiple RTIs. Overall, 4%, 27% and 69% of women had screening tool scores of 0, 1 or 2+, respectively. At a threshold of at least one scored criterion, the tool demonstrated high sensitivities (95%-97%) but low specificities (3%-4%) for detecting any RTI. Increasing the score threshold and/or inclusion of abnormal vaginal discharge marginally improved specificity.

Conclusion

The prevalence of RTIs observed in this population was high, and the screening tool had no discriminatory power to detect prevalent RTIs.

SUBMITTER: Langwenya N

PROVIDER: S-EPMC8020848 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundUnintended pregnancy leads to unsafe abortion, which is one of the commonest causes of maternal deaths in developing countries including Ghana. Lots of unintended pregnancies can be avoided using emergency contraceptives (EC). Emergency contraceptives are mostly used after unprotected sexual intercourse and have a ninety-nine percent chance of preventing unintended pregnancy when taken correctly. However, unlike other modern contraceptives such as condoms, emergency contraceptives cannot prevent sexually transmitted infections.ObjectivesThis study aimed at assessing the factors influencing the use of emergency contraceptives among reproductive-age women in the Kwadaso Municipality, Ghana.MethodsA community-based descriptive cross-sectional study design was conducted in three sub-municipalities of the Kwadaso Municipality. A multistage sampling method was used to select 312 women in their reproductive age within households. A simple random sampling method was first used to select the sub-municipalities (Kwadaso Central, Asuoyeboah, and Agric-Nzema). Participants were selected from households through a systematic sampling procedure and responses were solicited from women who consented to participate in the study. The selection was strictly dependent on the number of eligible women in a household, that is, in an event where more than one woman was found in a household, a simple random sampling method was used to select only one woman from that household. STATA 15.0 was used to analyse the data. Binary logistic regression was used to find the adjusted estimates and associations between EC use and the exposure variables. P-values ≤ 0.05 were considered statistically significant at 95% Confidence Interval (CI).ResultsThe findings showed that 79.67% of the women had ever used EC. Amongst them, 59.83% used EC following unexpected unprotected sex, and 24.69% used EC following failed coitus interruptus. Women's attitude towards EC (AOR = 8.52, p<0.001), religion (AOR = 4.56, p = 0.004), and monthly income (AOR = 0.29, p = 0.030) were found to have significant influence on their use of EC.ConclusionThe level of EC use among the women was high. Women's attitude towards EC, religion, and monthly income were the major factors influencing the use of EC. Thus, strategies to promote EC use should emphasize on addressing the attitude of women towards EC through sex education in schools, various religious institutions, and the community at large with the services of health authorities and support from governmental and non-governmental organizations whose focus is to address the need for reproductive health services in order to reduce the misconception regarding the use of EC.

Project description:IntroductionModern contraceptive methods are a scientifically effective method to control the fertility of reproductive-aged groups of people. The women's use of contraceptive methods creates a birth gap and limits the number of their children. The main objective of this study is to identify the significant determinant of modern contraceptive use of reproductive-aged women in Ethiopia.MethodsWe used data from 2019 Ethiopian Mini Demographic and Health Survey. This data was multi-level, taking into account factors at the individual and community levels. In order to capture the multi-level structure of this data and make more reliable and broadly applicable conclusions about the variables influencing the use of modern contraceptives at the individual and community levels, we employed a two-level mixed-effects logistic regression model. In addition, we used cross-tabulation analysis to know the percentage of modern contraception users (reproductive-aged women) across their socio-economic, demographic, and health characteristics. A total of 8196 reproductive aged (15-49) women were included in this study.ResultsFrom a total of 8196 reproductive-aged women, 2495(30.4%) were using modern contraceptive method and the rest 5701(69.6%) did not use any modern contraceptive methods. Among 2495 contraceptive users, 1657 (67.3%) used injections and 533 (21.7%) used implants/Norplant. At a 5% level of significance, the result from the two-level binary logistic regression model revealed that the predictors; Age of women, education level, religion, wealth index, knowledge of modern contraception method, number of died children, number of living children, family size, total children ever born and contextual region have significant effect on the use of modern contraception method.ConclusionReproductive-aged women in Ethiopia with more living children, residing in urban/agrarian region, younger, wealthier, married, and more educated, were more likely to be modern contraceptive users. The concerned bodies in Ethiopia should bring forward the intervention strategy and should expand the existed programs to improve the use of modern contraception methods among reproductive-aged women in Ethiopia. Especially, they should give special attention to reproductive-aged women of less income, resident in pastoralist region, less educated, unmarried, and haven't living child.