Ubin Pokharel

Graduation Year


Document Type




Degree Name

MS in Public Health (M.S.P.H.)

Degree Granting Department

Epidemiology and Biostatistics

Major Professor

Anna R. Giuliano, Ph.D.

Committee Member

Yougui Wu, Ph.D.

Committee Member

James A. Mortimer, Ph.D.

Committee Member

Lynette J. Menezes, Ph.D.

Committee Member

Staci Sudenga, Ph.D.


Chlamydia, EVRI, HPV,, HPV Vaccines, HSV-2, STI Co-infections


Objective: The objective of this study was to describe the prevalence of sexually transmitted co-infections and assess factors associated with a single infection and co-infections.

Methods: A total of 388 women were included in this study. At enrollment of the EVRI trial women were tested for five STIs: Human papilloma virus (HPV), Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus-2 (HSV-2) and Treponema pallidum. Prevalence of STI infections and proportion of women with different combinations of co-infections were calculated. Factors associated with single infection and STI co-infection were assessed using a polytomous logistic regression model and odds ratio (OR) and 95% confidence intervals (95% CI) were reported as the measure of association.

Results: Prevalence of a single STI and concurrent STI co-infections were high. Prevalence of chlamydia was 33%, syphilis 6%, HSV-2 46% and HPV 71%. The most common STI co-infection pattern was HPV-HSV (32%), followed by HPV-chlamydia (17%). The odds of single STI compared to no STIs was significantly lower for women who had education level of grade 7 compared to women who had some college or technical education (OR 0.16, 95% CI: 0.03-0.79).The odds of a single STI compared to no STIs were significantly higher (OR 3.02, 95% CI: 1.05-8.64) and the odds of concurrent STIs compared to no infection were significantly higher (OR 3.86, 95% CI: 1.42-10.48) for women with three or more lifetime partners compared to one life time partner.

Conclusions: STIs, single and multiple concurrent infections, are common among this cohort of South African women. These results strengthen the recommendation that STI screening and treatment needs to be a component of multiple intervention strategies among high-risk women residing in communities with high STI prevalence.

Included in

Epidemiology Commons