{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:57:57Z","timestamp":1789055877867,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011071","name":"FHI 360","doi-asserted-by":"crossref","award":["AID-674-A-14-00009"],"award-info":[{"award-number":["AID-674-A-14-00009"]}],"id":[{"id":"10.13039\/100011071","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sexually transmitted infection (STI) prevalence and incidence estimates for pregnant adolescents are under-reported. We estimated prevalence and incidence of STIs in pregnant adolescents (15\u201319 years) in comparison with pregnant women 20\u201324 and &gt;25 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnant women registering at primary care clinics in Umlazi, a periurban subdistrict in KwaZulu-Natal, South Africa, were enrolled in an HIV incidence cohort study during February 2017\u2013March 2018. Women were examined for abnormal vaginal discharge, received empirical treatment, tested for HIV-1 and had vaginal swabs taken at their first and a subsequent visit in the third trimester. Vaginal swabs were stored for STI testing at completion of study and tested for<jats:italic>Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae<\/jats:italic>and<jats:italic>Mycoplasma genitalium<\/jats:italic>using PCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 752 HIV-negative pregnant women were enrolled at a median gestational age of 17 weeks: 180 (23.9%), 291 (38.7%) and 281 (37.4%) in the 15\u201319, 20\u201324 and &gt;25 years age groups. Pregnant adolescents had an STI prevalence of 26.7% at baseline, not significantly lower than the 20\u201324 (34.7%, OR 1.4; 95% CI 1.0 to 2.1, p=0.09) and &gt;25 years (33.8%, OR 1.4; 95% CI 0.9 to 2.1, p=0.12) age groups.<jats:italic>T. vaginalis<\/jats:italic>(11.1%),<jats:italic>C. trachomatis<\/jats:italic>(7.8%) and<jats:italic>N. gonorrhoeae<\/jats:italic>(4.4%) were most prevalent in adolescents, a trend similar to the other age groups. Overall, 43.4% were symptomatic and treated at baseline. Overall, 40.7% (118 of 290) of women who tested negative for an STI at baseline tested positive at the repeat visit (incidence 19.5\/100 person years). STI incidence in pregnant adolescents was 23.9\/100 person years and comparable with older age groups (20.5\/100 person years and 16.2\/100 person years). At the repeat visit, 19.0% of all women with an STI were symptomatic and treated. Performance of syndromic management was poor at baseline (negative predictive value (NPV) 68.6%, positive predictive value (PPV) 34.0%) and at repeat visit (NPV 58.4%, PPV 34.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prevalence of asymptomatic curable STIs in pregnant adolescents is high and comparable with women &gt;20 years old. Adolescents remain at substantial risk of asymptomatic incident STIs during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2022-055658","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T17:25:34Z","timestamp":1684517134000},"page":"482-488","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["High incidence of asymptomatic genital tract infections in pregnancy in adolescent girls and young women: need for repeat aetiological screening"],"prefix":"10.1136","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1577-6381","authenticated-orcid":false,"given":"Vani","family":"Govender","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhayendre","family":"Moodley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megeshinee","family":"Naidoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Connoly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinaye","family":"Ngcapu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quarraisha","family":"Abdool Karim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"2023101702050772000_99.7.482.1","unstructured":"WHO fact sheet, 15 September 2022. 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