Prevalence and Correlates of Genital Infections Among Newly Diagnosed Human Immunodeficiency Virus-Infected Adults Entering Human Immunodeficiency Virus Care in Windhoek, Namibia.

Background: Identifying and treating genital infections including sexually transmitted infections (STI) among newly diagnosed human immunodeficiency virus (HIV)-infected individuals may benefit both public and individual health. We assessed prevalence of genital infections and their correlates among newly diagnosed HIV-infected individuals enrolling in HIV care services in Namibia. Methods: Newly diagnosed HIV-infected adults entering HIV care at 2 health facilities in Windhoek Namibia were recruited from December 2012 to March 2014. Participants provided behavioral and clinical data including CD4+ T lymphocyte counts. Genital and blood specimens were tested for gonorrhea Chlamydia trichomoniasis Mycoplasma genitalium syphilis bacterial vaginosis and vulvovaginal candidiasis. Results: Among 599 adults 56% were women and 15% reported consistent use of condoms in the past 6 months. The most common infections were bacterial vaginosis (37.2%) trichomoniasis (34.6%) and Chlamydia (14.6%) in women and M. genitalium (11.4%) in men. Correlates for trichomoniasis included being female (adjusted relative risk [aRR] 7.18; 95% confidence interval [CI] 4.07-12.65) higher education (aRR 0.58; 95% CI 0.38-0.89) and lower CD4 cell count (aRR 1.61; 95% CI 1.08-2.40). Being female (aRR 2.39; 95% CI 1.27-4.50) nonmarried (aRR 2.30; (95% CI 1.28-4.14) and having condomless sex (aRR 2.72; 95% CI 1.06-7.00) were independently associated with chlamydial infection. Across all infections female (aRR 2.31; 95% CI 1.79-2.98) nonmarried participants (aRR 1.29; 95% CI 1.06-1.59) had higher risk to present with any STI whereas pregnant women (aRR 1.16 95% CI 1.03-1.31) were at increased risk of any STI or reproductive tract infection.