Prevalence of Gynaecologic Morbidity in HIV-positive Women: A Comparison of Treated and Untreated Patients

Abstract

Background: The 1994 International Conference on Population and Development in Cairo, Egypt drew attention to comprehensive reproductive health for women. The central role of reproduction in the lives of women in many parts of the world is now recognized. We sought to determine the prevalence of gynaecologic morbidity in a cohort of HIV-positive women with a view to determining the effect of HAART on their frequency of occurrence. Methodology: This was a cross-sectional study conducted in the ambulatory care HIV treatment clinic at the Jos University Teaching Hospital. A total of 369 HIV-positive women aged between 15 to 64 years were recruited. Demographic data, history of reproductive organ conditions and use of HAART were obtained. Pelvic examination was carried and Pap smears were obtained for cytology and interpreted using the Bethesda terminology. Results are presented as frequencies and means/median values using appropriate tests of comparison. Results: The mean age for those on HAART was 34±7 and 33±7 years for the HAART-naive group (p = 0.08). Median duration on HAART use was 12 (IQR: 1-41) months. The frequencies of the following self-reported symptoms were significantly higher in the HAART naïve group compared to the HAART experienced group: abnormal vaginal discharge (21.6% vs 9.6%), vaginal itching (39.4% vs 16.7%), abnormal menstruation (36.9% vs 18.4%) and post coital bleeding (5.1% vs 1.8%). On examination, the HAART naïve patients also had higher frequencies of purulent vaginal discharge, cervical erosion, cervical excitation tenderness, contact bleeding, cervical polyp and squamous intraepithelial lesions. Conclusion: This study revealed a higher prevalence of gynaecologic morbidity in HIVpositive women who are HAART-naïve compared with those on HAART. Treating HIV-infection therefore has additional sex-specific benefits for women in terms of reproductive health morbidity.

Key Words HIV, HAART, Reproductive-organ, Nigeria