PREVALENCE AND RISK FACTORS FOR BACTERIA VAGINOSIS IN HIV POSITIVE WOMEN IN LAGOS UNIVERSITY TEACHING HOSPITA

Abstract

Background: The clinical importance of bacterial vaginosis (BV), an important
cause of vaginal infection, is the putative association with many adverse obstetrical
and gynecological outcomes, including premature rupture of the membranes,
chorioamnionitis, prematurity, low birth weight, pelvic inflamatory disease, persistent
human papilloma virus (HPV) infection and acquisition and genital shedding of HIV.
Knowledge of the risk factors for BV is critical for its prevention and management.
Objective: The aim of this study was to determine the risk factors for bacteria
vaginosis among HIV positive women in LUTH.
Methodology: This study was a case control study, 150 HIV positive women
attending the APIN (AIDS Prevention Initiative) clinic were recruited for the study
after a written consent was obtained. A structured predesigned questionnaire was
used to obtain information from each participant on the socio-economic status,
sexual history and practice, contraceptive usage, retroviral status and duration of
diagnosis, antiretroviral therapy, CD4 count, viral load and retroviral status of
spouse. After this, high vaginal swabs was taken and examined for the presence of
BV using the Nugent’s criteria. The data obtained were analysed using Epi-Info
Statistical software. The risk factors for bacteria vaginosis (BV) was determined by
comparing the cases (HIV positive women who have BV) with controls (HIV positive
women who do not have BV).
Results: The prevalence of BV in this study was 40.7%. There was no significant
association between age, parity, marital status, ethnicity, occupation, coitarrhe,
number of sexual partners, duration of HIV disease, antiretroviral (ARV) therapy,
type of ARV, CD4 count and BV. There was a significant association between the
duration of ARV therapy, viral load levels and BV with women who had been on ARV
therapy for more than 2 years less likely to have BV and those with high viral load at
increase risk of BV.
Conclusion: This study has shown that the prevalence of BV among HIV positive
women is high; HIV positive women have an increased risk for BV when the viral
load is very high. Also HIV positive women who had been on antiretroviral drugs for
a long period have reduced risk for BV.
HIV positive women recently diagnosed or those with high viral load should be
routinely screened for BV.

PREVALENCE AND RISK FACTORS FOR BACTERIA VAGINOSIS IN HIV POSITIVE WOMEN IN LAGOS UNIVERSITY TEACHING HOSPITA