{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:25:09Z","timestamp":1792041909062,"version":"4.4.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"crossref","award":["IISP39582"],"award-info":[{"award-number":["IISP39582"]}],"id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000054","name":"National cancer Institute","doi-asserted-by":"crossref","award":["K07 CA225404"],"award-info":[{"award-number":["K07 CA225404"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objective<\/jats:title><jats:p>Young women in South Africa are highly affected by sexually transmitted infections (STI), like<jats:italic>C<\/jats:italic>.<jats:italic>trachomatis<\/jats:italic>(CT) and<jats:italic>N<\/jats:italic>.<jats:italic>gonorrhoeae<\/jats:italic>(NG). We aimed to estimate the incidence of CT and NG, and its determinants, among young women from the Western Cape, South Africa, participating in an HPV vaccine trial (the EVRI study).<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>HIV-negative women aged 16\u201324 years were enrolled between October 2012 and July 2013. At enrolment and month 6 participants were screened for CT and NG (Anyplex CT\/NG real-time detection method). A questionnaire on demographic and sexual history characteristics was completed at enrolment and month 7. Treatment for CT and\/or NG was offered to infected participants. Incidence rates (IR) of CT and NG were estimated. Determinants of incident CT and NG infections were assessed using Poisson regression.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>365 women were tested for CT and\/or NG at least twice. Prevalence of CT and NG at baseline was 33.7% and 10.4%, respectively. Prevalence of co-infection with CT and NG was 7.1%. During 113.3 person-years (py), 48 incident CT infections were diagnosed (IR = 42.4 per 100 py, 95% confidence interval (CI) 31.9\u201356.2). Twenty-nine incident NG were diagnosed during 139.3 py (IR = 20.8 per 100 py, 95%CI 14.5\u201329.9). Prevalent CT infection at baseline was associated with incident CT (adjusted incidence rate ratio (aIRR) 5.8, 95%CI 3.0\u201311.23. More than three lifetime sex partners increased the risk for incident NG (3\u20134 partners aIRR = 7.3, 95%CI 2.1\u201326.0; \u22655 partners aIRR = 4.3, 95%CI 1.1\u201317.5).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>The IR of bacterial STIs among young women in the Western Cape is very high. Besides being previously infected and a higher lifetime number of sex partners, no other risk factors were found for CT and NG, suggesting that the majority of these women were at risk. This indicates the need for intensified prevention of STIs as well as screening and treatment programs to increase sexual health in this region.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0250871","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T17:27:53Z","timestamp":1620062873000},"page":"e0250871","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Incidence and risk factors of C. trachomatis and N. gonorrhoeae among young women from the Western Cape, South Africa: The EVRI study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-1501","authenticated-orcid":true,"given":"Vita W.","family":"Jongen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten F.","family":"Schim van der Loeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthys H.","family":"Botha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staci L.","family":"Sudenga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha E.","family":"Abrahamsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna R.","family":"Giuliano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"pone.0250871.ref001","unstructured":"World Health Organization (WHO). Report on global sexually transmitted infection surveillance, 2018. 2018."},{"issue":"8","key":"pone.0250871.ref002","doi-asserted-by":"crossref","first-page":"548","DOI":"10.2471\/BLT.18.228486","article-title":"Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016","volume":"97","author":"J Rowley","year":"2019","journal-title":"Bull World Health Organ"},{"issue":"Suppl 6","key":"pone.0250871.ref003","doi-asserted-by":"crossref","first-page":"e25355","DOI":"10.1002\/jia2.25355","article-title":"Sexually transmitted infections and HIV in the era of antiretroviral treatment and prevention: the biologic basis for epidemiologic synergy","volume":"22","author":"MS Cohen","year":"2019","journal-title":"J Int AIDS Soc"},{"issue":"11","key":"pone.0250871.ref004","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1097\/OLQ.0b013e3181812d15","article-title":"The effect of genital tract infections on HIV-1 shedding in the genital tract: a systematic review and meta-analysis","volume":"35","author":"LF Johnson","year":"2008","journal-title":"Sex Transm Dis"},{"key":"pone.0250871.ref005","unstructured":"World Health Organization (WHO). Number of new HIV infections. Estimates by country https:\/\/apps.who.int\/gho\/data\/view.main.22500A?lang=en2019 [06 August 2020]."},{"key":"pone.0250871.ref006","unstructured":"World Health Organization (WHO). Number of people (all ages) living with HIV. Estimates by country https:\/\/apps.who.int\/gho\/data\/view.main.22100?lang=en2019 [06 August 2020]."},{"issue":"10","key":"pone.0250871.ref007","doi-asserted-by":"crossref","first-page":"e0205863","DOI":"10.1371\/journal.pone.0205863","article-title":"Adult gonorrhea, chlamydia and syphilis prevalence, incidence, treatment and syndromic case reporting in South Africa: Estimates using the Spectrum-STI model, 1990\u20132017","volume":"13","author":"RS Kularatne","year":"2018","journal-title":"PLoS One"},{"issue":"8","key":"pone.0250871.ref008","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1177\/0956462418758224","article-title":"Genital Chlamydia trachomatis and Neisseria gonorrhoeae infections among women in sub-Saharan Africa: A structured review","volume":"29","author":"JH Dubbink","year":"2018","journal-title":"Int J STD AIDS"},{"issue":"1","key":"pone.0250871.ref009","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.1016\/S2352-3018(16)30186-2","article-title":"Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa: a community-wide phylogenetic study","volume":"4","author":"T de Oliveira","year":"2017","journal-title":"The Lancet HIV"},{"key":"pone.0250871.ref010","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ijid.2020.06.046","article-title":"Population prevalence of sexually transmitted infections in a high HIV burden district in KwaZulu-Natal, South Africa: Implications for HIV epidemic control","volume":"98","author":"ABM Kharsany","year":"2020","journal-title":"Int J Infect Dis"},{"key":"pone.0250871.ref011","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s13104-016-1887-8","article-title":"Prevalence of chlamydia among HIV positive and HIV negative patients in the Vhembe District as detected by real time PCR from urine samples","volume":"9","author":"TM Mafokwane","year":"2016","journal-title":"BMC Res Notes"},{"issue":"11","key":"pone.0250871.ref012","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1080\/09540121.2018.1468008","article-title":"Sexual behavior and HIV risk across the life course in rural South Africa: trends and comparisons","volume":"30","author":"B Houle","year":"2018","journal-title":"AIDS Care"},{"issue":"9734","key":"pone.0250871.ref013","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0140-6736(10)60548-X","article-title":"Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study","volume":"376","author":"RK Jewkes","year":"2010","journal-title":"The Lancet"},{"issue":"4","key":"pone.0250871.ref014","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/OLQ.0b013e318191ba01","article-title":"Risk factors for incidence of sexually transmitted infections among women in South Africa, Tanzania, and Zambia: results from HPTN 055 study","volume":"36","author":"S Kapiga","year":"2009","journal-title":"Sex Transm Dis"},{"issue":"2","key":"pone.0250871.ref015","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/QAI.0000000000001656","article-title":"HIV Risk Among Adolescent Girls and Young Women in Age-Disparate Partnerships: Evidence From KwaZulu-Natal, South Africa","volume":"78","author":"B Maughan-Brown","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"6","key":"pone.0250871.ref016","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/OLQ.0b013e318206c288","article-title":"The Incidence and Correlates of Symptomatic and Asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Selected Populations in Five Countries","volume":"38","author":"R Detels","year":"2011","journal-title":"Sexually Transmitted Diseases"},{"issue":"1","key":"pone.0250871.ref017","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1186\/s12879-018-3380-6","article-title":"A high burden of asymptomatic genital tract infections undermines the syndromic management approach among adolescents and young adults in South Africa: implications for HIV prevention efforts","volume":"18","author":"A Kaida","year":"2018","journal-title":"BMC Infect Dis"},{"issue":"1","key":"pone.0250871.ref018","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/infdis\/jis298","article-title":"Symptomatic Vaginal Discharge Is a Poor Predictor of Sexually Transmitted Infections and Genital Tract Inflammation in High-Risk Women in South Africa","volume":"206","author":"K Mlisana","year":"2012","journal-title":"The Journal of Infectious Diseases"},{"issue":"1","key":"pone.0250871.ref019","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/OLQ.0000000000000219","article-title":"High prevalence and incidence of asymptomatic sexually transmitted infections during pregnancy and postdelivery in KwaZulu Natal, South Africa","volume":"42","author":"D Moodley","year":"2015","journal-title":"Sex Transm Dis"},{"issue":"Suppl 2","key":"pone.0250871.ref020","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.1086\/652395","article-title":"Risk of sequelae after Chlamydia trachomatis genital infection in women","volume":"201","author":"CL Haggerty","year":"2010","journal-title":"J Infect Dis"},{"key":"pone.0250871.ref021","unstructured":"National Department of Health Republic of South Africa. First line comprehensive management and control of sexually transmitted infections (STIs). Protocol for the management of a person with a sexually transmitted infection. https:\/\/www.fidssa.co.za\/Guidelines2010."},{"issue":"5","key":"pone.0250871.ref022","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1136\/sextrans-2014-051537","article-title":"HPTN 035 phase II\/IIb randomised safety and effectiveness study of the vaginal microbicides BufferGel and 0.5% PRO 2000 for the prevention of sexually transmitted infections in women","volume":"90","author":"MB Guffey","year":"2014","journal-title":"Sex Transm Infect"},{"issue":"3","key":"pone.0250871.ref023","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/OLQ.0000000000000568","article-title":"Risk Factors for Incidence of Sexually Transmitted Infections Among Women in a Human Immunodeficiency Virus Chemoprevention Trial: VOICE (MTN-003)","volume":"44","author":"ZM Chirenje","year":"2017","journal-title":"Sex Transm Dis"},{"issue":"6","key":"pone.0250871.ref024","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.contraception.2009.06.007","article-title":"Use of injectable progestin contraception and risk of STI among South African women","volume":"80","author":"A Pettifor","year":"2009","journal-title":"Contraception"},{"issue":"11","key":"pone.0250871.ref025","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1093\/infdis\/jiy388","article-title":"Targeted Pregnancy and Human Immunodeficiency Virus Prevention Risk-Reduction Counseling for Young Women: Lessons Learned from Biomedical Prevention Trials","volume":"218","author":"G Ramjee","year":"2018","journal-title":"J Infect Dis"},{"issue":"6","key":"pone.0250871.ref026","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/OLQ.0b013e31820a8c2c","article-title":"African women recently infected with HIV-1 and HSV-2 have increased risk of acquiring Neisseria gonorrhoeae and Chlamydia trachomatis in the Methods for Improving Reproductive Health in Africa trial","volume":"38","author":"KK Venkatesh","year":"2011","journal-title":"Sex Transm Dis"},{"issue":"2","key":"pone.0250871.ref027","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/QAI.0000000000000425","article-title":"High HIV, HPV, and STI Prevalence Among Young Western Cape, South African Women: EVRI HIV Prevention Preparedness Trial","volume":"68","author":"AR Giuliano","year":"2015","journal-title":"JAIDS Journal of Acquired Immune Deficiency Syndromes"},{"issue":"2","key":"pone.0250871.ref028","doi-asserted-by":"crossref","first-page":"e25257","DOI":"10.1002\/jia2.25257","article-title":"Acquisition of Sexually Transmitted Infections among Women Using a Variety of Contraceptive Options: A prospective Study among High-risk African Women","volume":"22","author":"FM Kiweewa","year":"2019","journal-title":"J Int AIDS Soc"},{"issue":"12","key":"pone.0250871.ref029","doi-asserted-by":"crossref","first-page":"884","DOI":"10.7326\/M14-1022","article-title":"Screening for gonorrhea and Chlamydia: a systematic review for the U.S. Preventive Services Task Force","volume":"161","author":"B Zakher","year":"2014","journal-title":"Ann Intern Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0250871","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T06:03:36Z","timestamp":1698991416000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0250871"}},"subtitle":[],"editor":[{"given":"Remco PH","family":"Peters","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,5,3]]},"references-count":29,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0250871","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,3]]}}}