P138 High STI prevalence among HIV-exposed women planning for pregnancy in rural, southwestern uganda
Bibliographic record
Abstract
Background Many HIV-affected couples desire children. STIs increase risks of infertility, poor maternal and infant outcomes, and HIV acquisition. We introduced STI testing in southwestern Uganda to characterize STI epidemiology among HIV-exposed women planning for pregnancy. Methods The Healthy Families PrEP study is enrolling 150 HIV-uninfected women planning for pregnancy with a partner known or suspected to be living with HIV. At enrollment, women are offered comprehensive safer conception counseling, including TDF/FTC as PrEP. We integrated STI testing for Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Trichomonas vaginalis (TV) (via GeneXpert), and Syphilis (via immunochromatographic rapid testing confirmed by RPR). We calculated STI prevalence and compared differences among women with and without STI (Fisher’s exact test). Results Between June 2018 and January 2019, 63 women completed baseline STI testing. Median age was 28 (IQR 24–31) years. Seventeen participants (27%) had STIs, including CT-14%, NG-3%, TV-8%, Syphilis-6%, and 5% with two STIs. Women with STI were less likely to report prior pregnancy (13/17 (76%) vs. 45/46 (98%), p=0.02) and trended towards being more likely to report prior stillbirth (4/17 (24%) vs. 3/46 (7%), p=0.08). Women with STI were less likely to report having relationship power to negotiate condom use (7/17 (41%) vs. 27/46 (59%), p=0.26) and were younger (median age 26 vs. 29). PrEP uptake was high in both groups (16/17 (94%) vs. 42/46 (91%), p=1). Conclusion We describe a 27% curable STI prevalence among HIV-exposed women planning for pregnancy. Women with STI were less likely to have had a prior pregnancy and trended towards prior stillbirth, possibly due to undiagnosed STI. In an HIV-endemic setting with social pressures to conceive children, infertility may contribute to increased HIV and STI exposures and prevalence. These data highlight the importance of integrating STI testing into HIV prevention programs to maximize the health of women, children, and families. Disclosure No significant relationships.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".