P13.03
Background: South African adolescent females have been underrepresented in HIV prevention trials though they have a disproportionately high risk for HIV acquisition. We hypothesized that changes associated with puberty may influence this susceptibility.
Methods: The Women's Initiative in Sexual Health (WISH) study is investigating factors associated with HIV risk in young South African women, by enrolling HIV-negative adolescents between 16–22 years. This study plans to enroll 150 participants from Masiphumelele, Cape Town and 100 from Soweto, Johannesburg. As part of WISH, information on vaginal pH and the prevalence of STIs (C. trachomatis, N. gonorrhoea, T. vaginalis, M. genitalium, HSV-2, syphilis, candida) and bacterial vaginosis (BV) was collected. Participants were surveyed on sexual risk and hormonal contraceptive use.
Results: Preliminary results in 48 enrolled participants show the majority of adolescents used injectable hormone contraception (80% Nur-Isterate and 16% Depo-Provera), with only 4% choosing oral contraceptives. Almost all, 98%, of the participants self-identified as heterosexual. Their median age of sexual debut was reported to be 16 years (IQR 16-17); with their median lifetime number of sexual partners being 2 (range 1–5). Reported condom use with their last sex act was 70%. Of the participants, 20% had been pregnant and all carried to term. Although only 25% reported having had a previous symptomatic STI, approximately half of the women were infected with an STI at enrolment; with C. trachomatis being the most common by far. Furthermore, 40% had BV (Nugent>7), with a median vaginal pH of 4.9. While STI prevalence at follow-up visits declined following treatment, BV did not.
Conclusions: These data highlight the vulnerability of South African adolescent females to STIs, BV and potentially HIV despite self reported condom use. This study will provide insight into the reproductive health of South African adolescents and may influence the design of future preventative strategies.
