M.Sc (Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Background: Bacterial vaginosis (BV) results from a shift in normal vaginal flora and predisposes women to sexually transmitted infections (STI) including HIV. Risk factors for BV are not well understood. This analysis seeks to determine the disease frequency of BV, assess determinants of BV and quantify time to first BV episode in HIV negative women. Methods: Baseline and follow-up data from 1066 women was analysed in STATA10. Logistic regression was used to determine baseline factors associated with BV and Kaplan Meier survival analysis to estimate time to BV episode. Results: BV prevalence and incidence was estimated at 48.42% and 81 cases per 100 women years respectively. Controlling for age and education, women with Trichomonas vaginalis, Chlamydia trachomatis, Herpes Simplex Virus2 and lower socio-economic status were 67%- 380%, 31%-472%, 20%-220% and 4%-91% more likely to present with BV respectively. Consistent condom use and being a housewife or student was significantly (p<0.05) associated with lower prevalent BV, with a significant interaction between age and education (p<0.05). The median time to first BV episode was 9.7 months. Conclusion: The analysis identifies modifiable risk factors like condom use, injectable contraceptives and treatment of STIs which could potentially decrease the high BV disease burden.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / OBJECTIVE: Determine the impact of HIV-1 seroconversion on inflammatory cytokines in the rectal mucosa. SETTING: Secondary analysis of data from men who have sex with men and transgender women who participated in a HIV prevention trial Lima, Peru. METHODS: From July to December 2017, 605 men who have sex with men and transgender women were screened for rectal gonorrhea/chlamydia (GC/CT). Fifty GC/CT-positive cases were randomly selected and matched with 52 GC/CT-negative controls by age and number of receptive anal intercourse partners in the last month. All participants were HIV-negative at baseline and those with GC/CT at baseline and/or follow-up received appropriate antibiotic therapy. Participants underwent sponge collection of rectal secretions for the measurement of inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) and were screened for rectal GC/CT and HIV at baseline, 3 months, and 6 months. Wilcoxon rank-sum tests compared inflammatory cytokine levels between participants diagnosed with HIV during follow-up and persons who remained HIV-negative. RESULTS: Eight participants were diagnosed with HIV at the 3-month (n = 6) or 6-month (n = 2) visit. The median number of receptive anal intercourse partners in the month before HIV diagnosis was the same for those who acquired HIV and those who did not. There were no significant differences in inflammatory cytokine levels in rectal mucosa between participants who did and did not experience HIV seroconversion at any time point. CONCLUSIONS: Despite a surge in viral replication during acute infection, findings from this study suggest that there is no prolonged effect of HIV-1 seroconversion on inflammatory cytokine levels in the rectal mucosa. Copyright / National Institute of Allergy and Infectious Diseases / Revisión por pares