%0 Journal Article
%T Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV
%A Anna-Lise Williamson
%A Clive M Gray
%A David A Lewis
%A Etienne Muller
%A Francesca Chiodi
%A Glenda Gray
%A Heather B Jaspan
%A Hoyam Gamieldien
%A Janan Dietrich
%A Jo-Ann S Passmore
%A Linda-Gail Bekker
%A Lindi Masson
%A Nonhlanhla Mkhize
%A Shameem Z Jaumdally
%A Shaun L Barnabas
%A Smritee Dabee
%A Thomas J Hope
%A Venessa D Maseko
%A Zizipho Mbulawa
%A null
%J International Journal of STD & AIDS
%@ 1758-1052
%D 2018
%R 10.1177/0956462417740487
%X Adolescents in Africa are at high risk for HIV infection, other sexually transmitted infections (STIs) and bacterial vaginosis (BV). Since behavior and burden of STIs/BV may influence HIV risk, behavioral risk factors and prevalence of STIs/BV were compared in HIV-seronegative adolescent females (n£¿=£¿298; 16¨C22 years) from two South African communities (Soweto and Cape Town). STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1, HSV-2, Treponema pallidum, and Haemophilus ducreyi) were detected by multiplex polymerase chain reaction, human papillomavirus (HPV) by Roche Linear Array, and BV by Nugent scoring. Rates of BV (Nugent ¡Ý7; 46.6%) and HPV (66.8%) were high in both communities. Prevalence of C. trachomatis and N. gonorrhoeae were >2-fold higher in Cape Town than Soweto (Chlamydia: 42% [62/149] versus 18% [26/148], p£¿<£¿0.0001; gonorrhoea 11% [17/149] versus 5% [7/148], p£¿=£¿0.05). Only 24% of adolescents with vaginal discharge-causing STIs or BV were symptomatic. In South African adolescents, clinical symptoms compatible with vaginal discharge syndrome had a sensitivity of 23% and specificity of 85% for the diagnosis of discharge-causing STI or BV. In a region with high HIV prevalence and incidence, >70% of young women with treatable conditions that could enhance HIV risk would have been missed because they lacked symptoms associated with syndromic management
%K Female
%K adolescents
%K sexually transmitted infections
%K bacterial vaginosis
%K syndromic management
%U https://journals.sagepub.com/doi/full/10.1177/0956462417740487