{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:50:13Z","timestamp":1757616613799,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["5R01HD071804"],"award-info":[{"award-number":["5R01HD071804"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2020,5,27]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Reproductive tract infections (RTIs) are a major cause of morbidity and mortality, yet RTI testing remains limited in resource-constrained settings. We assessed performance of an existing RTI risk assessment screening tool among women living with HIV (WLHIV) considering intrauterine contraceptive (IUC) use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a cross-sectional analysis among WLHIV screened for participation in an IUC trial in Cape Town, South Africa (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01721798\">NCT01721798<\/jats:ext-link>). RTI testing included <jats:italic>Neisseria gonorrhoeae<\/jats:italic>, <jats:italic>Chlamydia trachomatis<\/jats:italic>, <jats:italic>Trichomonas vaginalis<\/jats:italic> and bacterial vaginosis. Tool scoring was based on five separately scored criteria: (1) age under 25 years, (2) cohabitation with a partner, (3) secondary education, (4) self-reported intermenstrual bleeding and (5) number of current sexual partners and condom use frequency (score 0\u20135). We assessed tool performance in detecting RTI at 0 vs 1\u20135, 0\u20131 vs 2\u20135 and 0\u20132 vs 3\u20135 score thresholds.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 303 women, 52% (n=157) reported antiretroviral therapy use and median age was 31 years. The prevalence of any RTI was 38% (gonorrhoea=7%, chlamydia=11%, trichomoniasis=12%\u2009and bacterial vaginosis=18%) and 8% of women had multiple RTIs. Overall, 4%, 27% and 69% of women had screening tool scores of 0, 1 or 2+, respectively. At a threshold of at least one scored criterion, the tool demonstrated high sensitivities (95%\u201397%) but low specificities (3%\u20134%) for detecting any RTI. Increasing the score threshold and\/or inclusion of abnormal vaginal discharge marginally improved specificity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The prevalence of RTIs observed in this population was high, and the screening tool had no discriminatory power to detect prevalent RTIs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2019-200494","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T17:17:38Z","timestamp":1593623858000},"page":"137-143","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Risk-based screening to identify reproductive tract infection among HIV-infected women desiring use of intrauterine contraceptives"],"prefix":"10.1136","volume":"47","clinical-trial-number":[{"clinical-trial-number":"nct01721798","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01721798","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7883-621X","authenticated-orcid":false,"given":"Nontokozo","family":"Langwenya","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa"},{"name":"Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine S.","family":"Todd","sequence":"additional","affiliation":[{"name":"Global Health, Population, and Nutrition Department, FHI 360, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, City University of New York, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald R.","family":"Hoover","sequence":"additional","affiliation":[{"name":"Department of Statistics and Biostatistics, Rutgers University, New Brunswick, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nai-Chung","family":"Hu","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa"},{"name":"Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Ronan","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Landon","family":"Myer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa"},{"name":"Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, Rondebosch, Western Cape, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"key":"2025090512305390000_47.2.137.1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143304"},{"key":"2025090512305390000_47.2.137.2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002511"},{"key":"2025090512305390000_47.2.137.3","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181a4f695"},{"key":"2025090512305390000_47.2.137.4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/ijgo.12507","article-title":"Women infected with HIV and the impact of associated sexually transmitted infections","volume":"142","author":"Reda","year":"2018","journal-title":"Int J Gynaecol Obstet"},{"key":"2025090512305390000_47.2.137.5","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.contraception.2015.06.012","article-title":"Risk-based screening for Chlamydia trachomatis and Neisseria gonorrhoeae prior to intrauterine device insertion","volume":"92","author":"Grentzer","year":"2015","journal-title":"Contraception"},{"key":"2025090512305390000_47.2.137.6","first-page":"621","article-title":"Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics","volume":"73","author":"Mayaud","year":"1995","journal-title":"Bull World Health Organ"},{"key":"2025090512305390000_47.2.137.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2000.00055.x"},{"key":"2025090512305390000_47.2.137.8","unstructured":"World Health Organization (WHO) . 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