Gynecological morbidity in HIV infected pregnant women has been largely ignored by research despite the frequency and severity of this condition, finds a study conducted among HIV positive women in Cameroon.
Gynecological morbidity is defined as "any condition, disease or dysfunction of the reproductive system that is not related to pregnancy, abortion or childbirth but may be related to sexual behavior." The study states that such gynecological conditions are frequent in women infected with Human Immunodeficiency Virus (HIV).
Cameroon is one of the sub-Saharan African countries with a high prevalence of HIV; 6.8% of women of reproductive age are HIV infected.
The study was aimed at comparing the prevalence of gynecological conditions among HIV infected and non-infected pregnant women.
Over two thousand pregnant women were screened for HIV, lower genital tract infections and lower genital tract neoplasia at booking antenatal visit.
About 10% of the women were found to be HIV positive. In addition, all lower genital tract infections except candidiasis were more prevalent among HIV positive compared to HIV negative women.
Both pregnancy and HIV predispose women to certain gynecological conditions because of modification of the immune system, states the study.
The study cites the Center for Disease Control and Prevention (CDC) classification system for HIV infection includes several gynecological conditions such as persistent, frequent or poorly responsive episodes of vaginal candidiasis, moderate or severe cervical intraepithelial neoplasia (CIN) and pelvic inflammatory disease (PID), chronic herpes simplex virus ulcers and invasive cervical cancer.
According to the study, titled "Gynaecological morbidity among HIV positive pregnant women in Cameroon," only HIV and syphilis are screened during antenatal care in Cameroon, despite the fact that HIV is known to be associated with other sexually transmitted infections.
There is a clear disconnect between practice and evidenced-based information which shows the infections that affect women during pregnancy. In itself, that disconnect between scientific evidence and actual practice is a trend common to many HIV and AIDS programs.
Scientific information about HIV and AIDS is still very much ignored in programs as implementers are mainly engrossed in work related to the social manifestation of the epidemic. But, in order to achieve progress against AIDS, there is need for program implementers to incorporate evidence-based recommendations into their programs.
The study, which compared the prevalence of gynecological morbidity among pregnant women according to their HIV serostatus identified during antenatal care, found sexually transmitted infections (STIs) and pre-invasive cervical lesions to be more prevalent among HIV infected pregnant women compared to their non-infected counterparts.
Previous studies have reported that sexually transmitted infections producing ulcerative lesions such as syphilis, chancroid and genital herpes simplex virus (HSV) are associated with a higher rate of HIV transmission. In addition, non-ulcerative STIs are also associated with a three- to five-fold increase in the risk of HIV acquisition.
According to the study, routine screening and treatment of STIs during antenatal care in Cameroon and other countries with similar social profiles needs to be conducted on a regular basis. For pregnant, antenatal care also offers an excellent entry point to encourage women to consider getting on AIDS treatment.
