P099 High prevalence of curable sexually transmitted infections among HIV-uninfected women planning for pregnancy in KwaZulu-Natal, South Africa

Background HIV-exposed women in African settings planning to conceive are at heightened risk of acquiring sexually transmitted infections (STIs). STIs can increase HIV acquisition risks and cause maternal and child morbidity. Here, we describe the prevalence of curable STIs among HIV-uninfected women planning pregnancy with a partner who is living with HIV or of unknown serostatus in an HIV-endemic setting (eThekwini, KwaZulu-Natal (KZN)). Methods This is a descriptive longitudinal sub-study nested within the Safer Conception for Women study. HIV-uninfected women, aged 18–35 years with personal or partner plans for pregnancy were enrolled from November 2019 in eThekwini, KZN. A questionnaire was administered, and women were examined for STIs, and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG) via PCR of a provider-collected swab, and Treponema Pallidum (TP) via TPHA testing. Women with symptomatic and/or laboratory-confirmed STIs are treated and provided with partner notification letters. Repeat sample collection is scheduled after six months, and during pregnancy. Here, we report on prevalent curable STIs at baseline. Results Among the 50 women enrolled, [median age: 24 (range: 19–33), HIV serostatus of partner: 47(94%) unknown], 3 (6%) reported STI symptoms, and 12 (24%) had curable STI organisms detected on laboratory testing. CT was the most frequent pathogen (6, 12%), followed by TV (5, 10%), NG (2, 4%) and MG (1, 2%). Two women had >1 STI pathogen. No TP was detected. Baseline demographic and sexual behavioural characteristics did not differ between women with and without STIs. Conclusion Our findings indicate a high prevalence of curable STIs, mostly asymptomatic, among HIV-uninfected women planning for a pregnancy in the next year. Given the impact of asymptomatic curable STIs on maternal and neonatal health, this population should be prioritized for objective STI testing.