High prevalence of sexually transmitted infections in pregnant women living in southern Brazil.

BACKGROUND Porto Alegre, Brazil has the highest rates of congenital syphilis and HIV in the country. Other treatable sexually transmitted infections (STIs) are associated with poor pregnancy and neonatal outcomes, but are only diagnosed by syndromic algorithms. METHODS Between September 2018 and November 2019, we offered all pregnant women clinic-based STI testing for HIV antibody and treponemal antibody (via lateral flow assay rapid tests provided by the Brazilian Government) and for Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis (via PCR-based testing provided by Gene Xpert, Sunnyvale Ca) in 10 public prenatal health clinics in Porto Alegre. Participating women answered a brief survey via audio computer assisted survey instrument regarding demographics, partnerships and sexual behaviors. All infected individuals received appropriate treatment and referrals. RESULTS Of 400 pregnant women recruited, 94 (24%) were diagnosed with an STI including 2% with HIV, 11% with syphilis, 9% with chlamydia, 1% with gonorrhea, 5% with trichomoniasis and 3% with more than one STI. In our multivariate analysis, younger age (AOR 1.1, 95% CI 1-1.2), being non-white (AOR 1.8, 95% CI 1.1-3.1), having less education (AOR 2 95% CI 1.2-3.4), having a relationship <1 year (AOR 2 95% CI 1.1-3.6), were all independent predictors of women having an STI. Endorsing symptoms of an STI (eg vaginal ulcers/lesions, vaginal discharge) was not predictive of having a laboratory diagnosed STI (OR 1.1, 95% CI 0.7-1.7). CONCLUSION Etiologic based screening for STIs was uniformly accepted by women attending both hospital-based and primary health clinics in the south of Brazil and can result in appropriate treatment of pregnant women.