Epidemiology of co-infections in pregnant women living with human immunodeficiency virus 1 in rural Gabon

TY - JOUR

T1 - Epidemiology of co-infections in pregnant women living with human immunodeficiency virus 1 in rural Gabon

T2 - a cross-sectional study

AU - Davi, Saskia Dede

AU - Okwu, Dearie Glory

AU - Luetgehetmann, Marc

AU - Abba, Frederique Mbang

AU - Aepfelbacher, Martin

AU - Endamne, Lillian Rene

AU - Alabi, Ayodele

AU - Zoleko-Manego, Rella

AU - Mombo-Ngoma, Ghyslain

AU - Mahmoudou, Saidou

AU - Addo, Marylyn Martina

AU - Ramharter, Michael

AU - Mischlinger, Johannes

N1 - © 2023. The Author(s).

PY - 2023/7/6

Y1 - 2023/7/6

N2 - BACKGROUND: There is no recent epidemiological data on HIV infection in Gabon, particularly in pregnant women. To close this gap, an HIV-prevalence survey was conducted among Gabonese pregnant women, followed by a cross-sectional case-control study in which the prevalence of various co-infections was compared between HIV-positive and HIV-negative pregnant women.METHODS: Between 2018 and 2019, data for the HIV-prevalence survey were collected retrospectively in 21 Gabonese antenatal care centres (ANCs). Subsequently, for the prospective co-infection study, all HIV-positive pregnant women were recruited who frequented the ANC in Lambaréné and a comparator sub-sample of HIV-negative pregnant women was recruited; these activities were performed from February 2019 to February 2020. The mean number of co-infections was ascertained and compared between HIV-positive and HIV-negative women. Additionally, the odds for being co-infected with at least one co-infection was evaluated and compared between HIV-positive and HIV-negative women.RESULTS: HIV-positivity was 3.9% (646/16,417) among pregnant women. 183 pregnant women were recruited in the co-infection study. 63% of HIV-positive and 75% of HIV-negative pregnant women had at least one co-infection. There was a trend indicating that HIV-negative women were more often co-infected with sexually transmitted infections (STIs) than HIV-positive women [mean (standard deviation, SD): 2.59 (1.04) vs 2.16 (1.35), respectively; P = 0.056]; this was not the case for vector-borne infections [mean (SD): 0.47 (0.72) vs 0.43 (0.63), respectively; P = 0.59].CONCLUSIONS: Counterintuitively, the crude odds for concomitant STIs was lower in HIV-positive than in HIV-negative women. The change of magnitude from the crude to adjusted OR is indicative for a differential sexual risk factor profile among HIV-positive and HIV-negative women in this population. This might potentially be explained by the availability of sexual health care counselling for HIV-positive women within the framework of the national HIV control programme, while no such similar overall service exists for HIV-negative women. This highlights the importance of easy access to sexual healthcare education programmes for all pregnant women irrespective of HIV status.

AB - BACKGROUND: There is no recent epidemiological data on HIV infection in Gabon, particularly in pregnant women. To close this gap, an HIV-prevalence survey was conducted among Gabonese pregnant women, followed by a cross-sectional case-control study in which the prevalence of various co-infections was compared between HIV-positive and HIV-negative pregnant women.METHODS: Between 2018 and 2019, data for the HIV-prevalence survey were collected retrospectively in 21 Gabonese antenatal care centres (ANCs). Subsequently, for the prospective co-infection study, all HIV-positive pregnant women were recruited who frequented the ANC in Lambaréné and a comparator sub-sample of HIV-negative pregnant women was recruited; these activities were performed from February 2019 to February 2020. The mean number of co-infections was ascertained and compared between HIV-positive and HIV-negative women. Additionally, the odds for being co-infected with at least one co-infection was evaluated and compared between HIV-positive and HIV-negative women.RESULTS: HIV-positivity was 3.9% (646/16,417) among pregnant women. 183 pregnant women were recruited in the co-infection study. 63% of HIV-positive and 75% of HIV-negative pregnant women had at least one co-infection. There was a trend indicating that HIV-negative women were more often co-infected with sexually transmitted infections (STIs) than HIV-positive women [mean (standard deviation, SD): 2.59 (1.04) vs 2.16 (1.35), respectively; P = 0.056]; this was not the case for vector-borne infections [mean (SD): 0.47 (0.72) vs 0.43 (0.63), respectively; P = 0.59].CONCLUSIONS: Counterintuitively, the crude odds for concomitant STIs was lower in HIV-positive than in HIV-negative women. The change of magnitude from the crude to adjusted OR is indicative for a differential sexual risk factor profile among HIV-positive and HIV-negative women in this population. This might potentially be explained by the availability of sexual health care counselling for HIV-positive women within the framework of the national HIV control programme, while no such similar overall service exists for HIV-negative women. This highlights the importance of easy access to sexual healthcare education programmes for all pregnant women irrespective of HIV status.

KW - Female

KW - Pregnancy

KW - Humans

KW - HIV Infections/complications

KW - Pregnant Women

KW - Cross-Sectional Studies

KW - HIV-1

KW - Pregnancy Complications, Infectious/epidemiology

KW - Coinfection/epidemiology

KW - Prospective Studies

KW - Retrospective Studies

KW - Case-Control Studies

KW - Gabon/epidemiology

KW - Sexually Transmitted Diseases/epidemiology

KW - Prevalence

U2 - 10.1186/s40249-023-01114-y

DO - 10.1186/s40249-023-01114-y

M3 - Short publication

C2 - 37408012

VL - 12

JO - INFECT DIS POVERTY

JF - INFECT DIS POVERTY

SN - 2095-5162

IS - 1

M1 - 64

ER -