Ms. Justine Umutesi

Ms. Justine Umutesi |Clyto Access

University of Rwanda, Rwanda

Speaker

Expertise:

Biography: Ms. Justine Umutesi is pesently pursuing her Masters in field of Epidemiology and Laboratory Management at University of Rwanda. she completed her Bachelors Degree in Public Health at Saint Josephs University. She has membership in many professional bodies such as  Member of Association of Nurses in AIDS care,  Akron/Ohio. Member and secretary of Alumni Network of Field Epidemiologist of Rwanda . Her key qualifications are Field epidemiologist , Academic degree in public health , Academic Degree in Mid-Wifely etc.,

Presentation:

Title: Prevalence and factors associated with self-reported STIs among HIV-positive individuals aged 15-49 years in Rwanda (2014-2015)

Abstract:

Background: Data shows a strong association between sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), with co-infection accelerating the progression of HIV and increasing the risk of HIV transmission. Our objective was to determine the prevalence of STIs in HIV-positive individuals in Rwanda and to determine key risk factors for STIs in this population. 

Methods: Our study was a cross-sectional analysis of the Rwanda Demographic and Health Survey (DHS) 2014-15 which included 380 HIV-infected people aged 15-49 years. We analyzed sociodemographic variables and conducted bivariate analysis to measure potential associations between covariates and STIs. Variables which were significant in bivariate models (p≤0.1) were entered into the multivariate model; p≤0.05 was considered significant. STI was defined as any self-reported STI, genital discharge, or genital sores within the last 12 months. 

Results: A total of 380 respondents were HIV positive and approximately 67% were female. The mean age was 34.6 (±8.8). STIs were observed in 73 HIV+ people leading to a prevalence of 19.2% (95%CI 15.5-23.5). In bivariate analysis, people from Western and Eastern Provinces were more likely to have STIs compared by those in Kigali (OR 2.39 [95%CI 1.12-5.15] and 2.66 [1.27-5.62] respectively). Female gender (OR 1.59 [0.94-2.69]) and high risk partnership (OR 2.87 [1.50-5.50]) were associated with STIs infection. Conversely, people who attained secondary school education (OR 0.25[0.08-0.77]) and those aged 18 years and above were less likely to have STIs (OR 0.31 [0.18-0.54]). Surprisingly individuals who reported condom use were more likely to have STIs (OR 2.19[1.29-3.73]). In multivariate analysis, Eastern province (OR 3.56 [1.47-8.64]) and high risk partnership (OR 3.67 [1.31-10.24]) remained significantly associated with STIs, while secondary school attainment (OR 0.21 [0.06-0.80]) and age above 18 (OR 0.32 [0.17-0.64]) were protective.

Conclusion: Infection with an STI is very common in individuals infected with HIV in Rwanda. Strengthening STI education surrounding correct condom use, reduction of extramarital partnerships and delaying sexual activity initiation is necessary. Clear definition of condom use in the DHS is also needed for a better understanding of this important component in sexual and reproductive health.

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Title: Prevalence and factors associated with hepatitis B and C infection in persons living with HIV enrolled in care in Rwanda

Abstract:

Background: Hepatitis B (HBV) and C (HCV) are important causes of morbidity and mortality in people living with human immunodeficiency virus (PLHIV). However the burden of these co-infections in Rwanda is still unclear. We estimated the prevalence of the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCVAb) among PLHIV in Rwanda and identified factors associated with infection.

Methods: Between January 2016 and June 2016, systematic screening for HBsAg and HCVAb was performed in PLHIV enrolled at public and private HIV facilities across Rwanda; 117,258 individuals were reached, 65% of total PLHIV enrolled to care. Results were analyzed to determine marker prevalence overall and by demographic factors. Multivariate logistic regression models were performed, applying survey weighting to ensure representative estimates. Odds ratios (ORs) were used as the measure of association and were considered significant at p<0.05.

Results: Overall, the prevalence of HBsAg and HCVAb was 4.3% (95%CI 4.2-4.4) and 4.6% (95%CI 4.5-4.7) respectively; 182 (0.2%) HIV+ individuals were co-infected with HBsAg and HCVAb. Prevalence was higher in males (HBsAg, 5.4% [5.1-5.6] vs. 3.7% [3.5-3.8]; HCVAb, 5.0% [4.8-5.2] vs. 4.4% [4.3-4.6]) and increased with age; HCVAb prevalence was dramatically higher in people aged ≥65 years (17.8% [16.4-19.2]). In multivariate analysis, male gender (1.47 [1.20-1.80]) was associated with HBsAg positivity; being <15 years was protective against HBsAg (0.42 [0.23-0.75], ref. age 35-44). For HCVAb, older age was associated with positivity (age 45-54, 1.25 [1.01-1.54]; age 55-64, 2.46 [1.96-3.10]; age ≥65, 5.49 [3.85-7.83]) and younger age was protective (age <15, 0.39 [0.23-0.67]; age 15-24, 0.46 [0.26-0.81]). Compared with living in Kigali, living in the Western province was associated with lower odds of HCVAb (0.77 [0.60-1.00]).

Conclusion: HBV and HCV co-infections are common in PLHIV in Rwanda. It is important that viral hepatitis prevention and treatment activities are scaled-up to control further transmission and reduce the burden in PLHIV. Special efforts should be made to conduct targeted screening of males and the older population. Further assessment is required to determine rates of HBV and HCV chronicity among PLHIV and to outline strategies to link individuals to care.
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Related Conferences :

International Conference on STDs and HIV