The effects of injectable hormonal contraceptives on HIV seroconversion and on sexually transmitted infections

Introduction. The aim of this study was to investigate the sexual behavior, attitudes and knowledge on contraception, sexually transmitted infections and reproductive health among the youth in Bosnia and Herzegovina. Material and Methods. A prospective study included a sample of 6.000 subjects, aged 19-24, of both sexes, investigating the sexual behavior of the youth in Bosnia and Herzegovina in the period 2007 - 2009. Results. Of the interviewed examinees, 61% were sexually active, of which 56.4% had sexual intercourse with one partner (z = 28.51; p < 0.001). The average age of sexarche was significantly lower in males 17.34 ? 1.77 years, than in females 18.20 ? 1.84 years (z = -14.44; p < 0.001). Contraception was used by 67.6% at first intercourse, and by 70.4% at the last intercourse. The most common method of contraception was male condom (74%), coitus interruptus (11.1%), and oral hormonal contraceptives (14.9%). The examined subjects had inadequate knowledge (51.6%) about contraceptive methods, and it was significantly higher in males (64.6%) than in females (42.2%) (z = 10.17; p < 0.001). Some 4.9% of the sexually active females had intentional abortions. Up to 51.7% of females had never had a pelvic examination, and Pap test was done by 37.2%. The examinees obtained information about contraception and sexually transmitted infections from peers 50.7% and parents 9.7%. Only 28% of females had a positive attitude towards oral hormonal contraceptives. Conclusion. The interviewed young people in Bosnia and Herzegovina keep traditional sexual behavior patterns, attitudes and practices. However, more effort should be put into the improvement of knowledge on contraception, sexually transmitted infections, and healthcare protection.

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Impact of recurrent sexually transmitted infections on HIV seroconversion: Results from multi-state frailty models

International Journal of STD & AIDS ◽

10.1177/09564624211036587 ◽

2021 ◽

pp. 095646242110365

Author(s):

Handan Wand ◽

Jayajothi Moodley ◽

Tarylee Reddy ◽

Sarita Naidoo

Keyword(s):

Sexually Transmitted Infections ◽

Critical Role ◽

Population Level ◽

Frailty Models ◽

African Women ◽

Cumulative Impact ◽

Sexually Transmitted ◽

Hiv Seroconversion ◽

The Impact

After several decades of research, South Africa is still considered to be the epicentre of HIV epidemic. The country also has the highest burden of sexually transmitted infections (STIs) which have been frequently linked to increasing rates of HIV transmission due to biological and behavioural associations between these two pathogeneses. We investigated the cumulative impact of recurrent STIs on subsequent HIV seroconversion among a cohort of South African women. We used the ‘ frailty’ models which can account for the heterogeneity due to the recurrent STIs in a longitudinal setting. The lowest HIV incidence rate was 5.0/100 person-year among women who had no baseline STI and remained negative during the follow-up. This estimate was three times higher among those who had recurrent STIs in the follow-up period regardless of their STI status at baseline (15.8 and 14.0/100 person-year for women with and without STI diagnosis at baseline, respectively). Besides younger age and certain partnership characteristics, our data provided compelling evidence for the impact of recurrent STI. diagnoses on increasing rates of HIV. At the population-level, 65% of HIV infections collectively associated with recurrent STIs. These results have significant clinical and epidemiological implications and may play critical role in the trajectory of the infections in the region.

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