GET Journal of Biosecurity and One Health

GET Journal of Biosecurity and One Health (2023)

The Prevalence and Correlates of Sexually Transmitted Infections (STIs) among Heterosexual HIV-1 Sero-Discordant Couples Enrolled into HIV Prevention Clinical Trial in Western Kenya

Authors:Kipyego J*1,2, Oketch D 1, Kaguiri E 1, Komen A1, Kutwa G1,
Sawe J1, Ballidawa J1, 3, Ayuo P1, 4, Were E1, 5

GET Journal of Biosecurity and One Health, Volume 2, Issue 2, (2023)

Article Keywords: STIs; HIV; Clinical trial; Discordant Couple


Journal Volume & Issue

Volume 2, Issue 2


Volume 1, No. 4, 2022

Pages 34-40

Ebola Survivors are not at Increased Risk for Gynecologic Surgeries

Gorpudolo-Dennis N1; Kennedy SB2*; Reilly C3 and Sankoh M1

1Department of Obstetrics and Gynecology, Redemption Hospital, New Kru Town, Montserrado County, Monrovia, Liberia.

2UL-PIRE Africa Center, An Infectious Disease Research Center, Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia.

3Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA.

*Corresponding Author: Stephen B. Kennedy, MD, MPH, UL-PIRE Africa Center, An Infectious Disease Research Center
Ground Floor, Graduate School Building, University of Liberia, Monrovia, Liberia. Tel: +231 770 645 830

Orchid No:


As the result of multiple signs and symptoms, and complications observed among survivors of the Ebola virus disease (EVD), there is an assumption that survivors might experience perturbations within their clotting parameters. This may eventually lead to increased bleeding time, predisposing them to increased risk for surgical complications. This study aimed to comparatively review specific intra-operative parameters such as uterine fibroids and polyps among a number of EVD survivors and non survivors undergoing elective gynecologic surgeries at Redemption Hospital, a tertiary specialized referral hospital located within one of the EVD hotspots, in Liberia from January to October 2016. A case-control study was conducted wherein cases were referred from the Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), an EVD clinical trial platform, while controls were sampled from the general patient population, at Redemption Hospital. The controls were matched based on age, employment status and parity. All surgeries were performed by single surgeon based on a surgical checklist that included designated intra- and post-operative parameters. Statistical analysis such as counts, percentiles, confidence intervals and relative risks were performed to assess the differences between the cases and controls, respectively. Survivors were between the ages of 42 years and 44 years for controls with an average interval between discharge from the Ebola Treatment Unit (ETU) and surgical intervention of greater than one year. The median duration of surgical procedure was 60 minutes and blood loss of 250 ml in both groups. Besides the relative risks (RR) of receiving antibiotics for more than 3 days of 1.5 (85.7% vs. 57.1%) and hospitalization of more than 7 days of 0.25 (14% vs. 57%) for survivors as compared to controls, most of the indicators were not significantly different. The findings revealed that EVD survivors who present with benign tumors such as uterine fibroids, polyps, or adenomyosis, requiring elective uterine surgery such as myomectomy and/or hysterectomy are generally not at increased risk of surgical complications because most of the indicators (hospitalization, blood loss, antibiotics, etc.) were not significantly different between the two groups. Findings from this study may potentially revise the approaches used by gynecologists and general surgeons during encounters and/or interventions with patient(s) concerning emerging infectious diseases (EIDs).

Keywords: Ebola Virus Disease (EVD), Emerging Infectious Diseases (EIDs), Ebola Survivors, Uterine Surgery, Females, Liberia


Sexually transmitted infections (STIs) are a major public health concern. Annually, over 300 million
infections are reported worldwide, with 75-85% occurring in developing countries, with an estimated one million cases occurring daily. HIV-discordant couples remain at increased risk of transmission of HIV and STIs. Improved patient education is crucial in reducing the transmission of STIs, and to achieve this optimally, new strategies need to be developed. This study sought to determine the prevalence and risk factors associated with STIs in a cohort of heterosexual HIV-1 discordant couples in Western Kenya. A cross-sectional study of healthy heterosexual HIV-1discordant couples from Western Kenya enrolled into the Partners PrEP Study Eldoret site between September 2008 and October 2010. Socio-demographic data was obtained using specific case report forms. All participants were screened for the four classical STIs using Treponema Pallidum Hemagglutination Assay (TPHA) for Syphilis and nucleic acid amplification for Gonorrhea, Trichomonas, and Chlamydia. Descriptive statistics was used to determine frequencies, while the association between the STIs and the independent variables was evaluated using logistic regression. Data for 938 participants were available for analysis, of whom 469 (50%, 320 women, 149 men) were HIV-infected. The median was 26.97 years (IQR 23.52-31.93); (HIV-negative 35 years (IQR 29-40), and HIV-positive years (26-39). Prevalence was as follows: Chlamydia 11 (1.1%), Gonorrhea 7 (0.7%), Syphilis 14 (1.4%) and Trichomonas 55 (5.5%). There was no association between the presence of STIs and age, education, income, and gender. HIV-positive participants who reported alcohol intake were almost three times more likely to be diagnosed with an STI compared to those who did not take alcohol. [OR 2.841; 95% CI 1.16 – 6.95; p value 0.02] Those who were circumcised were one and a half times more likely to test negative for an STI compared to those who were uncircumcised, but this was not statistically significant [OR 1.556; 95% CI 0.980-2.472; p-value 0.061]. Focused counseling messages should be developed to target HIV-infected partners who (ab)use alcohol.