Gynecological
morbidity in HIV infected pregnant women has been largely ignored by research
despite the frequency and severity of this condition, finds a study
conducted among HIV positive women in Cameroon.

Gynecological
morbidity is defined as "any condition, disease or dysfunction of the
reproductive system that is not related to pregnancy, abortion or childbirth
but may be related to sexual behavior." The study states that such gynecological
conditions are frequent in women infected with Human Immunodeficiency Virus
(HIV).

Cameroon is one of the sub-Saharan African
countries with a high prevalence of HIV; 6.8% of women of reproductive age are
HIV infected.

The study
was aimed at comparing the prevalence of gynecological
conditions among HIV infected and non-infected pregnant women.

Over two thousand pregnant
women were screened for HIV, lower genital tract infections and lower genital
tract neoplasia at booking antenatal visit.

About 10%
of the women were found to be HIV positive. In addition, all lower genital
tract infections except candidiasis were more prevalent among HIV positive compared
to HIV negative women.

Both
pregnancy and HIV predispose women to certain gynecological conditions because
of modification of the immune system, states the study.

The study
cites the Center for Disease Control and Prevention (CDC) classification system
for HIV infection includes several gynecological conditions such as persistent,
frequent or poorly responsive episodes of vaginal candidiasis, moderate or
severe cervical intraepithelial neoplasia (CIN) and pelvic inflammatory disease
(PID), chronic herpes simplex virus ulcers and invasive cervical cancer.

According
to the study, titled "Gynaecological
morbidity among HIV positive pregnant women in Cameroon," only HIV and
syphilis are screened during antenatal care in Cameroon, despite the fact that HIV
is known to be associated with other sexually transmitted infections.

There is
a clear disconnect between practice and evidenced-based information which shows
the infections that affect women during pregnancy. In itself, that disconnect
between scientific evidence and actual practice is a trend common to many HIV
and AIDS programs.

Scientific
information about HIV and AIDS is still very much ignored in programs as
implementers are mainly engrossed in work related to the social manifestation
of the epidemic. But, in order to achieve progress against AIDS, there is need
for program implementers to incorporate evidence-based recommendations into
their programs.

The study,
which compared the prevalence of gynecological morbidity among pregnant women according to their HIV serostatus identified during antenatal care, found sexually
transmitted infections (STIs) and pre-invasive cervical lesions to be more
prevalent among HIV infected pregnant women compared to their non-infected counterparts.

Previous
studies have reported that sexually transmitted infections producing ulcerative
lesions such as syphilis, chancroid and genital herpes simplex virus (HSV) are associated
with a higher rate of HIV transmission. In addition, non-ulcerative STIs are
also associated with a three- to five-fold increase in the risk of HIV
acquisition.

According
to the study, routine screening and treatment of STIs during antenatal care in Cameroon and
other countries with similar social profiles needs to be conducted on a regular
basis. For pregnant, antenatal care also offers an excellent entry point to
encourage women to consider getting on AIDS treatment.