CHLAMYDIAL AND GONOCOCCAL CERVICITIS IN HIV-SEROPOSITIVE AND HIV-SERONEGATIVE PREGNANT-WOMEN IN BANGKOK - PREVALENCE, RISK-FACTORS, AND RELATION TO PERINATAL HIV TRANSMISSION

Objectives: To determine the prevalence and risk factors associated wi th cervicitis caused by Chlamydia trachomatis and Neisseria gonorrhoea e in human immunodeficiency virus (HIV) type 1-seropositive and HIV-se ronegative pregnant women in Bangkok, and the relation to perinatal HI V transmission, Methods: As part of a multicenter perinatal HIV transm ission study in an antenatal population with 2% HIV seroprevalence, en docervical swabs obtained at mid-pregnancy from a consecutive sample o f 222 HIV-seropositive and 219 HIV-seronegative pregnant women at two large hospitals in Bangkok were tested for the presence of C. trachoma tis and N. gonorrhoeae by DNA hybridization probe (Gen-Probe), Clinica l risk factors and DNA probe results were analyzed in relation to the women's and newborns' HIV infection status, Results: The prevalence of C. trachomatis was 16.2% in HIV-seropositive pregnant women and 9.1% in HIV-seronegative pregnant women (P = 0.03), The prevalence of N. go norrhoeae was 2.7% in HIV-seropositive pregnant women and 1.4% in HIV- seronegative pregnant women (P = 0.5), The overall population prevalen ce estimate was 9.2% for C. trachomatis and 1.4% for N. gonorrhoeae. W omen with gonococcal infection were more likely to be positive for C. trachomatis (RRMH = 5.2, P < 0.01), Young age (<21 years) and primigra vid status were associated with C. trachomatis infection among HIV-ser opositive women; history of multiple sex partners (>1) were associated with C. trachomatis infection among HIV-seronegative women, For HIV-s eropositive women, primigravida status also was associated with C. tra chomatis infection. The perinatal HIV transmission rates were similar for those with and without C. trachomatis (24.1% and 23.2%, P = 0.9) a nd among those with and without N. gonorrhoeae (20% and 23.5%, P = 1.0 ), Conclusions: Among pregnant women in Bangkok, C. trachomatis infect ion was considerably more common than N. gonorrhoeae infection and was associated with HIV infection, young age and first pregnancy (HIV-ser opositive women), and multiple partners (HIV-seronegative women), Our data do not suggest an association between perinatal HIV transmission and maternal C. trachomatis or N. gonorrhoeae infection identified and treated during pregnancy, The high prevalence of C. trachomatis found using a test not readily available in Thailand emphasizes the need fo r improved, inexpensive ways to screen for and diagnose these sexually transmitted infections in developing countries.