Sexual violence, HSV-2 and HIV are important predictors for infertility in Rwanda

Authors: Dhont, N.; van de Wijgert, J.; Luchters, S.; Muvunyi, C.; Vyankandondera, J.; Temmerman, M.

Source: Human Reproduction, Volume 25, Number 10, 18 October 2010 , pp. 2507-2515(9)

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Abstract:

BACKGROUND

In order to formulate cost-effective health interventions aimed at preventing infertility it is necessary to identify modifiable risk factors for infertility in sub-Saharan Africa. This casecontrol study examined potential predictors and their population attributable fraction (PAF) for various infertility types including lifestyle factors, sexual behaviour and reproductive tract infections (RTIs).

METHODS

Sexually active women aged 2145 year presenting with infertility problems at the infertility clinic of the Kigali University Teaching Hospital (n 312), and fertile controls who recently delivered (n 283) were surveyed together with their male partners. Participants were interviewed about socio-demographic characteristics, sexual behaviours and lifestyle factors, and were tested for HIV and RTIs.

RESULTS

Variables significantly associated with tubal infertility were history of sexual violence [adjusted odds ratio (AOR) 2.41; 95 CI 1.364.25]; positive HIV (AOR 2.41; 95 CI 1.364.25), herpes simplex virus type 2 (HSV-2; AOR 1.67; 95 CI 1.032.71) and Chlamydia trachomatis serology (AOR 1.78; 95 CI 0.993.21), and current bacterial vaginosis by Amsel criteria (AOR 1.97; 95 CI 1.123.47). Among men, male factor infertility was associated with positive HIV (AOR 2.43; 95 CI 1.315.23) and HSV-2 serology (AOR 1.71; 95 CI 1.022.87) and current urologic abnormalities (AOR 2.38; 95 CI 1.015.31). Positive HSV-2 serostatus carried the greatest PAF (26) for tubal infertility, followed by positive HIV serostatus (20) and history of sexual violence (17).

CONCLUSIONS

Although temporal relationships are difficult to ascertain, history of sexual violence, HSV-2 infection and HIV infection are important predictors of infertility in Rwanda.

Keywords: infertility; tubal factor; male factor; Africa; predictors

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/deq189

Publication date: 2010-10-18

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

Sexual violence, HSV-2 and HIV are important predictors for infertility in Rwanda

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