1. Population-Level Correlation Between Incidence of Curable Sexually Transmitted Infections and Human Immunodeficiency Virus (HIV)-1 Among African Women Participating in HIV-1 Pre-Exposure Prophylaxis Trials.
- Author
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Hunidzarira, Portia, Brown, Elizabeth R, Chirenje, Z Mike, Hillier, Sharon L, Marrazzo, Jeanne M, Palanee-Phillips, Thesla, Kiweewa, Flavia M, and Baeten, Jared M
- Subjects
Biomedical and Clinical Sciences ,Public Health ,Clinical Sciences ,Health Sciences ,Medical Microbiology ,Mental Health ,Clinical Trials and Supportive Activities ,HIV/AIDS ,Clinical Research ,Infectious Diseases ,Prevention ,Sexually Transmitted Infections ,2.2 Factors relating to the physical environment ,Aetiology ,Infection ,Good Health and Well Being ,Chlamydia Infections ,Chlamydia trachomatis ,Female ,HIV Infections ,HIV-1 ,Humans ,Incidence ,Neisseria gonorrhoeae ,Pre-Exposure Prophylaxis ,Prevalence ,Sexually Transmitted Diseases ,clinical trial design ,HIV incidence ,sexually transmitted infections ,women ,MTN-003/VOICE and MTN-020/ASPIRE Study Teams ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Biological sciences ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundHighly efficacious oral pre-exposure prophylaxis (PrEP) is the global standard for human immunodeficiency virus (HIV)-1 prevention, including in clinical trials of novel PrEP agents using active-comparator designs. The analysis assessed whether incident sexually transmitted infections (STIs) can serve as a surrogate indicator of HIV-1 incidence that might occur in the absence of PrEP.MethodsWe analyzed data from 3256 women randomized to placebo groups of oral and vaginal PrEP trials (MTN-003/VOICE and MTN-020/ASPIRE). Regression modeling assessed the correlation between incident individual STIs (Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis, each considered separately) and incident HIV-1.ResultsAcross 18 sites in 4 countries (Malawi, South Africa, Uganda, Zimbabwe), STI and HIV-1 incidences were high: HIV-1 4.9, N gonorrhoeae 5.3, C trachomatis 14.5, and T vaginalis 7.1 per 100 person-years. There was limited correlation between HIV-1 incidence and incidence of individual STIs: N gonorrhoeae (r = 0.02, P = .871), C trachomatis (r = 0.49, P =
- Published
- 2022