The changing relationship between bacterial STIs and HIV prevalence in South Africa - an ecological study.

Kenyon, CR; Osbak, K; Buyze, J; Chico, RM; (2014) The changing relationship between bacterial STIs and HIV prevalence in South Africa - an ecological study. International journal of STD & AIDS. ISSN 0956-4624 DOI:

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BACKGROUND Prevalence estimates of various bacterial sexually transmitted infections in South Africa have declined considerably since the mid-1990s. Syphilis among pregnant women, for example, declined from 10.8% in 1998 to 2.8% in 2001. METHODS Pearson's correlation coefficients were estimated for association between the prevalence of syphilis/male urethral discharge/male genital ulcers and the peak HIV prevalence at a district and provincial level in the early and late phases of the HIV epidemic in South Africa. RESULTS Prevalence estimates of syphilis, male urethral discharge and male genital ulcers during the period preceding the peak HIV prevalence were all positively correlated with the peak HIV prevalence at a provincial level (Pearson's correlation coefficient [r] = 0.83, p = 0.006; r = 0.66, p = 0.052; r = 0.79, 0.011, respectively). These relationships all switched to a negative association later in the HIV epidemic at a provincial level (r = -0.53, p = 0.14; r = -0.73, p = 0.130; r = -0.54, p = 0.027, respectively). CONCLUSION AIDS mortality may have played an important role in the decline of bacterial sexually transmitted infections such as syphilis in this region. Consequently, the relatively recent scale-up of antiretroviral therapy may result in a resurgence of syphilis and other sexually transmitted infections as observed in high-income countries.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
PubMed ID: 25122576
Web of Science ID: 356006100006


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