{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T08:30:40Z","timestamp":1783413040214,"version":"3.54.6"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD096937-01"],"award-info":[{"award-number":["R01HD096937-01"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000308","name":"Carnegie Corporation of New York","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000308","id-type":"DOI","asserted-by":"publisher"}]},{"name":"South African National Research Foundation"},{"name":"Australian National Health and Medical Research Council","award":["APP1195837"],"award-info":[{"award-number":["APP1195837"]}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1032115"],"award-info":[{"award-number":["OPP1032115"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID-OAA-A-15-00045"],"award-info":[{"award-number":["AID-OAA-A-15-00045"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004441","name":"Swedish International Development Cooperation Agency","doi-asserted-by":"crossref","award":["2017\/762965-0"],"award-info":[{"award-number":["2017\/762965-0"]}],"id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"crossref"}]},{"name":"South Africa Medical Research Council"},{"DOI":"10.13039\/100006661","name":"United Nations Population Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>South Africa is among the countries with the highest prevalence of sexually transmitted infections (STIs), including <jats:italic>Chlamydia trachomatis<\/jats:italic> (CT) and <jats:italic>Neisseria gonorrhoeae<\/jats:italic> (NG). In 2017, there were an estimated 6 million new CT, 4.5 million NG and 71 000 <jats:italic>Treponema pallidum<\/jats:italic> infections among South African men and women of reproductive age.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We evaluated STI prevalence and incidence and associated risk factors in 162 women aged 18\u201333 years old, residing in eThekwini and Tshwane, South Africa who were part of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial. Women were randomised to use depot medroxyprogesterone acetate (n = 53), copper intrauterine device (n = 51), or levonorgestrel (n = 58) implant. Lateral vaginal wall swab samples were collected prior to contraceptive initiation and at months one and three following contraceptive initiation for STI testing.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were no significant differences in STI incidence and prevalence across contraceptive groups. At baseline, 40% had active STIs (CT, NG, <jats:italic>Trichomonas vaginalis<\/jats:italic> (TV), <jats:italic>Mycoplasma genitalium<\/jats:italic> (MG) or herpes simplex virus-2 shedding across all age groups\u2013 18\u201321 years (46%), 22\u201325 years (42%) and 26\u201333 years (29%). The incidence of STIs during follow-up was exceptionally high (107.9\/100 women-years [wy]), with younger women (18\u201321 years) more likely to acquire CT (75.9\/100 wy) compared to 26\u201333 year olds (17.4\/100 wy; p = 0.049). TV incidence was higher in the 26\u201333 year old group (82.7\/100 wy) compared to the 18\u201321 year olds (8.4\/100 wy; p = 0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Although the study participants received extensive counselling on the importance of condom use, this study highlights the high prevalence and incidence of STIs in South African women, especially amongst young women, emphasising the need for better STI screening and management strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0294285","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T18:28:22Z","timestamp":1699640902000},"page":"e0294285","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence and incidence of sexually transmitted infections among South African women initiating injectable and long-acting 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