Williams AB, Andrews S, Frankel R, Tashima K, Mezger JA; National Conference on Women & HIV.

Natl Conf Women HIV Natl Conf Women HIV Innov Care Policy Prev 1997 Los Angel Calif. 1997 May 4-7; 182 (abstract no. P2.38).

Yale University, School of Nursing, New Haven, CT.

Objective: To describe factors associated with vulvo-vaginal candidiasis (VVC) and candida vaginitis (CV) among women with HIV infection. Methods: Baseline analysis of history, physical findings and laboratory studies of data provided by 184 HIV + women enrolled in a prospective clinical trial. VVC was defined as a vaginal swab positive for yeast without symptoms. A case of CV required the presence of symptoms, microscopic visualization of hyphae, and a vaginal swab positive for yeast. Results: The cohort was 46% African-American; 38% white; 13% Hispanic. The median age was 36 and median CD4 was 330. Seventy-five percent had a history of drug use with 34% currently using drugs. Fifty-two percent were taking anti-retroviral medication; 44% also took other antibiotics. Sixty-four women (35%) had vaginal swabs positive for yeasts; of these 52 (81%) were Candida albicans. 19 women met the case definition for CV. None of the following factors was associated with either VVC or CV: race, current illicit drug use, current antiretroviral or antibiotic use, reported condom use, self-report of current yeast infections, or vaginal pH. CV, but not VVC, was associated with age under 40 (p=.03) and CD4 less than or equal to 100 cell/mm(3) (p=.01). In a logistic regression model, only CD4 less than or equal to 100 cell/mm(3) was predictive of CV (Adjusted Odds Ratio 6.0; 95% CI 1.5, 24; p=.001). Self-report of CV was only 11% sensitive and 85% specific for current clinical disease. The predictive value of self-report was 9%. Sixty-seven percent of women felt fear or embarrassment in anticipation of pelvic examination. Discussion: Although vaginal yeast infection was common (35%) in this group, the risk for clinical disease was most dramatically increased among women with CD4 less than or equal to 100 cells/mm(3). Self-report did not adequately identify women with disease, confirming the importance of comprehensive gynecologic evaluations.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Candida albicans
• Candidiasis, Vulvovaginal
• Female
• HIV Infections
• HIV Seropositivity
• Humans
• Longitudinal Studies
• Odds Ratio
• Vulvovaginitis

Other ID:

• 97927531

UI: 102226139

From Meeting Abstracts