{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:06:19Z","timestamp":1772737579316,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Sexually transmitted infections (STIs), including syphilis, chlamydia, gonorrhoea and trichomoniasis, are of global public health concern. While STI incidence rates in sub\u2010Saharan Africa are high, longitudinal data on incidence and recurrence of STIs are scarce, particularly in rural areas. We determined the incidence rates of curable STIs in HIV\u2010negative women during 96\u2009weeks in a rural South African setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively followed participants enrolled in a randomised controlled trial to evaluate the safety and efficacy of a dapivirine\u2010containing vaginal ring for HIV prevention in Limpopo province, South Africa. Participants were included if they were female, aged 18\u201345, sexually active, not pregnant and HIV\u2010negative. Twelve\u2010weekly laboratory STI testing was performed during 96\u2009weeks of follow\u2010up. Treatment was provided based on vaginal discharge by physical examination or after a laboratory\u2010confirmed STI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 119 women were included in the study. Prevalence of one or more STIs at baseline was 35.3%. Over 182 person\u2010years at risk (PYAR), a total of 149 incident STIs were diagnosed in 75 (65.2%) women with incidence rates of 45.6 events\/PYAR for chlamydia, 27.4 events\/100 PYAR for gonorrhoea and 8.2 events\/100 PYAR for trichomoniasis. Forty\u2010four women developed \u22652 incident STIs. Risk factors for incident STI were in a relationship \u22643\u2009years (adjusted hazard ratio [aHR]: 1.86; 95% confidece interval [CI]: 1.04\u20132.65) and having an STI at baseline (aHR: 1.66; 95% CI: 1.17\u20132.96). Sensitivity and specificity of vaginal discharge for laboratory\u2010confirmed STI were 23.6% and 87.7%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates high STI incidence in HIV\u2010negative women in rural South Africa. Sensitivity of vaginal discharge was poor and STI recurrence rates were high, highlighting the shortcomings of syndromic management in the face of asymptomatic STIs in this setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13864","type":"journal-article","created":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T12:39:45Z","timestamp":1678019985000},"page":"335-342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence, incidence and recurrence of sexually transmitted infections in <scp>HIV<\/scp>\u2010negative adult women in a rural South African setting"],"prefix":"10.1111","volume":"28","author":[{"given":"Laura E. P.","family":"Huyveneers","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathapelo","family":"Maphanga","sequence":"additional","affiliation":[{"name":"Ndlovu Research Centre  Elandsdoorn Limpopo South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chijioke N.","family":"Umunnakwe","sequence":"additional","affiliation":[{"name":"Ndlovu Research Centre  Elandsdoorn Limpopo South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa","family":"Bosman\u2010de Boer","sequence":"additional","affiliation":[{"name":"Ndlovu Research Centre  Elandsdoorn Limpopo South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S.","family":"Moraba","sequence":"additional","affiliation":[{"name":"Ndlovu Research Centre  Elandsdoorn Limpopo South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo A.","family":"Tempelman","sequence":"additional","affiliation":[{"name":"Ndlovu Research Centre  Elandsdoorn Limpopo South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie M. J.","family":"Wensing","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology University Medical Center Utrecht  Utrecht The Netherlands"},{"name":"Ezintsha University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas E.","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology University Medical Center Utrecht  Utrecht The Netherlands"},{"name":"Ezintsha University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Internal Medicine Groote Schuur Hospital  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization.Global health sector strategies on HIV viral hepatitis and sexually transmitted infections 2022\u20132030. World Health Organization. Global HIV Hepatitis and STIs Programmes (who.int); 2016. Accessed 10 Dec 2022."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00448-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002472"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003163"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.2010.00942"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000232"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462420915388"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/10158782.2012.11441502"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112597"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03340230057031"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-116-3-197"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajid.v36i1.296"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0025-7125(16)30485-0"},{"issue":"1","key":"e_1_2_7_15_1","first-page":"22","article-title":"Unrecognized sexually transmitted infections in rural South African women: a hidden epidemic","volume":"77","author":"Wilkinson D","year":"1999","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462417724908"},{"key":"e_1_2_7_17_1","unstructured":"South African Department of Health.Sexually Transmitted Infections Management Guidelines 2018; 2018. Available from:https:\/\/www.health.gov.za\/wp-content\/uploads\/2020\/11\/sti-guidelines-27-08-19.pdf. Accessed 1 May 2022."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12742"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30310-9"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.18502\/ijrm.v17i9.5093"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602046"},{"key":"e_1_2_7_22_1","unstructured":"Elias Motsoaledi Local Municipality.Summary of the 2019\u20132020 Integrated Development Plan (IPD) as adopted by the Municipal Council on the 28th May 2019. Available from:https:\/\/www.eliasmotsoaledi.gov.za\/sstaff\/pages\/sites\/emlm\/documents\/idp\/SUMMARY%20OF%202019\u20102020%20IDP%20FOR%20PUBLISHING.pdf. Accessed 10 Dec 2022."},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215353"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004089"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002512"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002511"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000931"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.06.046"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.851635"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000568"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25257"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318191ba01"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6405-11-31"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/09564624211036587"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.032011"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2010.010005"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2010.08.006"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis298"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-016-1990-x"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/104973230223874"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5909-4"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462420915395"},{"key":"e_1_2_7_43_1","unstructured":"Limpopo Provincial AIDS Council.Annual Progress Report 2015\/16 Provincial Strategic Plan 2012\u20132016; 2017:7. Accessed 20 May 2022."}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13864","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.13864","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.13864","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T14:26:12Z","timestamp":1692714372000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.13864"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,13]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/tmi.13864"],"URL":"https:\/\/doi.org\/10.1111\/tmi.13864","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,13]]},"assertion":[{"value":"2023-03-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}