(Co-Infections Study) The Epidemiology of HIV/STI Co-Infections among African and Caribbean Women in Toronto

Project Name:

Co-Infections Study

Funding Dates:

Status:

Completed

Principal Investigators:

Robert S Remis, Juan Liu, Mona Loutfy, Wangari Tharao, Anuradha Rebbapragada, Stephen J Perusini, Lisungu Chieza, Megan Saunders, LoriAnn Green-Walker, and Rupert Kaul

Description:

HIV infection is frequent in African and Caribbean women in Ontario, with a rate 24-fold greater than other women. Therefore, we aimed to characterize the epidemiology of HIV and other sexually transmitted infections (STIs) in African-Caribbean (AC) women in Toronto and to apply this knowledge to support community and public health interventions.

Purpose and Objectives:

Method:

Participants completed a socio-behavioural questionnaire using Audio Computer Assisted Self-Interview (ACASI) and provided blood for syphilis, HIV, hepatitis B and C, herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), and human cytomegalovirus (CMV) serology, urine for chlamydia and gonorrhea molecular testing and vaginal secretions for bacterial vaginosis (BV) and human papillomavirus (HPV).

Population:

Women 16 years of age or older from Africa and the Caribbean living in Greater Toronto. Women were eligible if they self-identified as African or Caribbean and if they, a parent, or grandparent were born in sub-Saharan Africa or the Caribbean.

Region:

GTA

Start and End Date:

2009-2010

Results:

We recruited 126 HIV-positive and 291 HIV-negative women, with a median age of 40 and 31 years, respectively (p < 0.001). Active HBV infection and lifetime exposure to HBV infection were more common in HIV-positive women (4.8% vs. 0.34%, p = 0.004; and 47.6% vs. 21.2%, p < 0.0001), as was a self-reported history of HBV vaccination (66.1% vs. 44.0%, p = 0.0001). Classical STIs were rare in both groups; BV prevalence was low and did not vary by HIV status. HSV-2 infection was markedly more frequent in HIV-positive (86.3%) than HIV-negative (46.6%) women (p < 0.0001). Vaginal HPV infection was also more common in HIV-positive than in HIV-negative women (50.8% vs. 22.6%, p < 0.0001) as was infection with high-risk oncogenic HPV types (48.4% vs. 17.3%, p < 0.0001).

Project Indicators and Outcomes:

Funding Sources:

CIHR

Keywords: