GYNECOLOGICAL CONDITIONS ASSOCIATED WITH HIV-INFECTION IN WOMEN WHO ARE PARTNERS OF HIV-POSITIVE THAI BLOOD-DONORS

Women who were partners of HIV-positive blood donors were enrolled in a study of heterosexual HIV transmission between March 1992 and Decemb er 1996 and were interviewed and examined. Gynaecological conditions, including cervical dysplasia, human papillomavirus (HPV) infection, go norrhoea, chlamydial infection, trichomoniasis, bacterial vaginosis, v aginal candidiasis and syphilis were assessed in addition to HIV statu s and CD4 level. Of 481 women enrolled, 224 (46.6%) were HIV seroposit ive. HIV-infected women were more likely to have abnormal vaginal disc harge on physical examination (OR=2.6, P<0.01), HPV infection with a h igh-risk type (OR=6.9, P<0.01), and cervical dysplasia (OR=5.3, P<0.01 ). The prevalence of other gynaecological conditions detected at the e nrolment visit did not differ by HN status. History of prior STD (OR=2 .0, P<0.01) was more common among HIV-infected women. The median CD4 c ount was 400 cells/mu l among HIV-infected women. The prevalence of ab normal vaginal discharge and bacterial vaginosis increased significant ly with decreasing CD4 count. The prevalence of ectopy, vaginal candid iasis, and cervical dysplasia increased with decreasing CD4 count, but these trends were not significant. We conclude that HV-infected Thai women appear to have increased prevalences of abnormal vaginal dischar ge, squamous intraepithelial lesions and self-reported history of STD.