P49.11
Background: Sexually Transmitted Infections (STIs) facilitate transmission and acquisition of HIV infection. Screening for STIs is recommended in HIV microbicide trials and untreated STIs delay enrolment. We determined the burden of STIs among high risk women screened for a Phase III microbicide trial in Southwestern Uganda.
Methods: The Medical Research Council/Uganda Virus Research Institute (MRC/UVRI) in collaboration with International Partnership for Microbicides (IPM) is evaluating safety and efficacy of a dapivirine vaginal ring among healthy HIV-negative high risk women in a multicentre Phase III trial. These women were identified from bars, lodges, restaurants, and hair salons in townships and fishing communities within 50 km from the research centre. High risk was defined by presence of STIs, self-reported unprotected sex with multiple sex partners, and frequent use of recreational drugs (marijuana, alcohol) in the past 3 months. All consenting female volunteers were screened for STIs regardless of clinical symptoms. Cervico-vaginal samples were taken for T. vaginalis (OSOM Rapid test), C. trachomatis/N. gonorrhoeae (Roche PCR test), and blood samples taken for syphilis (RPR/TPHA). Treatment was as per the Uganda National guidelines for syndromic management and CDC STI treatment guidelines. The proportion of STIs among the women screened was determined.
Results: Of the 236 women screened between August 2013 and March 2014, the mean age was 28 years (range 18 to 42 years). About half (111, 47%) had T. vaginalis, 23 (10%) C. Trachomatis, 20 (8%) N. gonorrhoeae and 12 (5%) syphilis (RPR and TPHA positive). A total of 43 (18.2%) had at least 2 or more STIs.
Conclusions: There is a high burden of STIs among high risk women. Though such populations are considered suitable for vaginal microbicide efficacy trials, the high STI burden impacts greatly on trial enrolment. There is a need for regular STI screening, partner identification and treatment, and condom promotion in this population.
