Association between Mycoplasma genitalium infection and HIV acquisition among female sex workers in Uganda: evidence from a nested case-control study

Judith Vandepitte, Helen A Weiss, Justine Bukenya, Nassim Kyakuwa, Etienne Muller, Anne Buvé, Patrick Van der Stuyft, Richard J Hayes, Heiner Grosskurth

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    OBJECTIVES: Cross-sectional studies have shown a strong association between Mycoplasma genitalium and HIV infections. We previously reported that in a cohort of female sex workers in Uganda, M genitalium infection at baseline was associated with HIV seroconversion. Here we examine the temporal association between the M genitalium infection status shortly before HIV seroconversion and HIV acquisition.

    METHODS: A nested case-control study was conducted within a cohort of women at high risk for HIV in Kampala. Cases were those of women acquiring HIV within 2 years of enrolment. For each of the 42 cases, 3 controls were selected from women HIV negative at the visit when the corresponding case first tested HIV seropositive. The association between HIV acquisition and M genitalium infection immediately prior to HIV testing was analysed using conditional logistic regression.

    RESULTS: There was weak evidence of an association between M genitalium infection and HIV acquisition overall (crude OR=1.57; 95% CI 0.67 to 3.72, aOR=2.28: 95% CI 0.81 to 6.47). However, time of M genitalium testing affected the association (p value for effect-modification=0.004). For 29 case-control sets with endocervical samples tested 3 months prior to the first HIV-positive result, M genitalium infection increased the risk of HIV acquisition (crude OR=3.09; 95% CI 1.06 to 9.05, aOR=7.19; 95% CI 1.68 to 30.77), whereas there was little evidence of an association among the 13 case-control sets with samples tested at an earlier visit (crude OR=0.30: 95% CI 0.04 to 2.51; aOR=0.34; 95% CI 0.02 to 5.94).

    CONCLUSIONS: Our study showed evidence of a temporal relationship between M genitalium infection and HIV acquisition that suggests that M genitalium infection may be a co-factor in the acquisition of HIV infection.

    Original languageEnglish
    JournalSexually Transmitted Infections
    Issue number7
    Pages (from-to)545-549
    Number of pages5
    Publication statusPublished - 2014


    • Viral diseases
    • HIV
    • AIDS
    • Sexually transmitted diseases
    • STD
    • Mycoplasma genitalium
    • Prostitutes
    • Associations
    • Risk
    • Cofactors
    • Uganda
    • Africa-East


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