Clinical Characteristics Associated With Mycoplasma Genitalium Among Female Sex Workers In Nairobi, Kenya

Abstract

Prevalence of Mycoplasma genitalium is higher in vulnerable populations of women in low-resource settings. However the epidemiology of infection in these populations is not well established. To determine the prevalence of Mycoplasma genitalium and its association with cervical cytology and other correlates, we recruited 350 female sex workers (FSW) aged 18-50 years old in Nairobi, Kenya for a cross-sectional study. A questionnaire was administered at baseline to obtain information on sociodemographics and sexual behaviors. Women underwent a pelvic exam during which a physician collected cervical exfoliated samples for conventional cytology and sexually transmitted infections (STI) testing. Samples were tested for M. genitalium and other STIs (C. trachomatis, N. gonorrhoeae, T. vaginalis) and E6/E7 mRNA of HPV, using APTIMA nucleic amplification assays. Prevalence of M. genitalium was 12.9%. FSW who engaged in sexual intercourse during menses were less likely to have M. genitalium infection than those who did not (OR [95% CI] = 0.3 [0.1, 0.9]). M. genitalium was also less prevalent among FSW who worked in prostitution for >5 years (6.2%) compared to those who worked for <3 years (17.6%; OR[95% CI] = 0.3 [0.1, 0.8]). FSW who reported more frequent condom use were more likely to be infected with M. genitalium relative to those who reported less frequent use (OR [95% CI] = 3.8 [1.2, 11.6]). These correlates differ from those found in M. genitalium studies conducted in FSW from Sub-Saharan Africa and China. Further longitudinal analyses assessing associations with persistent M. genitalium are needed.