Sammendrag
We evaluated the prevalence and association of Genital Ulcer Diseases (GUDs) among HIV-1 infected female commercial sex workers (FCSWs) in Ibadan, Nigeria. A total of 25O FCSWs from brothels in Ibadan were tested for presence of antibodies to HIV and Syphilis. Pelvic examinations for signs of sexually transmitted infections (STIs) were carried out on the subjects. Endocervical and
high vaginal swabs were collected from each of the subjects to establish laboratory diagnosis of STIs. Their age ranged from 15 to 55 years (Mean = 25.8yrs; SD =3.74). Majority (246/250) were Nigerians, while 1.6% were from neighboring West African countries. Sixty four (25.6%) of the subjects were positive for HIV-1 while seven (2.8%) had dual HIV-1/2 infection. Analysis of the STIs
showed that 49 (19.6%) of the CSWs had GUDs. Herpes genitalis was the commonest GUDs as it occurred in 25 (10%) of the subjects. Other STIs identified were chancroid (5.6%), syphilis (4.0%) and lymphogranuloma venerum (LGV) (4%). Sixteen (64.0%) of the CSWs with herpes genitalis had HIV-1 infection. The risk ratio of herpes genitalis for HIV acquisition was 3.0 (95% CI: 2.0 – 4.4). Syphilis and chancroid were also found to be significantly associated with increased risk of HIV infection (p<0.0001). The adjusted odd ratios for Herpes genitalis, chancroid, and syphilis were 3.7(1-13.0, p<0.05), 19.8 (2.7-13 .0, p<0.05) and 19.1(1- 231.0, p < 0.05) respectively. There is need to educate FCSWs continually to adopt safer sexual behaviours, seek early diagnosis and treatment of GUDs to reduce their risk of transmitting HIV infection.
Keywords: Genital, ulcers, female, sex, workers
Résumé
Nous avons évalué la prévalence et l’association des maladies d’ulcère génitale (MUG) parmi les femmes Prostituées a Ibadan, Nigeria. Un total de 250 femmes prostituées de motels à Ibadan étaient testées à cause de la présence des anticorps au VIH et a la syphilis, l’examen du pelvis pour des signes d’infections sexuellement transmises (IST) était faite sur les sujets. Les secrétions vaginales et endocervicales étaient collectées de chaque sujet et soumis a des diagnostiques de IST. Leurs tranche d’âge variait entre 15 et 55 ans (Moyenne =25.8ans; SD = 3.74). La majorité (246/250) étaient Nigérianes, alors que 1.6% était originaire des pays Ouest Africain voisins. Soixante quatre (25.6%) des sujets était positif au VIH-1 alors que (2.8%) avait une infection combine de VIH-1 / 2. Les analyses des IST ont montrées que 49 (19.6%) des prostitués avait des maladies d’ulcere Génitale. L’Herpès génitale était le plus commun des MUG vue qu’il était présent chez 25 (10%) des sujets. Les autres IST identifiées étaient le chancre mou (5.6%), la syphilis (4.0%) et le lymphogranulome venerum (LGV) (4%). Seize (64%) de ces femmes ayant l’herpès Génital était infectées du VIH-1. La proportion de risque de l’herpès génitale pour l’acquisition du VIH était 3.0 (95% CI: 2.0 – 4.4). La Syphilis et le chancre mou étaient aussi détectés comme étant significativement associé a l’augmentation des risques d’infection du VIH (P<0.0001). Des proportions ajustées pour l’herpès génitale, le chancre mou, et la syphilis étaient 3.7 (1-13.0, P<0.05), 19.8 (2.7-13 .0, P<0.05) and 19.1 (1-231.0, P < 0.05) respectivement. Il est nécessaire d’éduquer continuellement les prostitués a adopter des comportements sexuel sain, a faire des diagnostiques et des traitements des MUG tôt afin de réduire leurs risque de transmission de l’infection du VIH.
Correspondence: Dr. SA Fayemiwo, Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria. Email: dayteet@yahoo.com
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