Lower genital tract infections among HIV-infected and high-risk uninfectedwomen - Findings of the Women's Interagency HIV Study (WIHS)

Background and Objectives: Few comparisons of factors associated with sexua lly transmitted diseases (STDs) and HIV are available for representative sa mples of American women. Goal of the Study: To compare factors associated with STDs in a large sampl e of women infected with HIV and women not infected with HIV. Study Design: A cross-sectional analysis of STDs in 2,058 women seropositiv e (HIV+) for HIV and 567 women seronegative (HIV-) for HIV. Results: HIV+ women were more likely than HIV- women to report previous STD s, with the exceptions of chlamydia and bacterial vaginosis. Both HIV statu s and CD4 lymphocyte count were associated with evidence of genital ulcerat ions, warts, and vaginal candidiasis (p < 0.001 for all). HIV- women were m ore apt to report recent vaginal intercourse (p < 0,001), a factor that was independently associated with the occurrence of bacterial and protozoan in fections. CD4 lymphocyte depletion was the factor most closely associated w ith the expression of chronic viral infections. Conclusions: In this North American cohort, HIV+ women were more likely tha n HIV- women to report previous genital tract infections and symptoms. Howe ver, the HIV+ women reported less recent sexual activity and few gonococcal or chlamydial infections.