Research Article HIV Status and Other Risk Factors for Prevalent and Incident Sexually Transmitted Infection during Pregnancy (2000-2014) Jodie Dionne-Odom , 1 Michelle J. Khan, 2 Victoria C. Jauk, 3 Jeff Szychowski, 3,4 Dustin M. Long, 4 Suzanne Wallace, 1 Cherry Neely, 3 Karen Fry, 1 Jeanne Marrazzo, 1 Marilyn Crain, 5 and Alan T. N. Tita 3 1 Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA 2 Departments of Obstetrics and Gynecology and Adult and Family Medicine, Kaiser Permanente, San Leandro, California, USA 3 Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Center for Women’s Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama, USA 4 Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA 5 Department of Pediatrics, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA Correspondence should be addressed to Jodie Dionne-Odom; jdionne@uabmc.edu Received 15 November 2018; Revised 28 February 2019; Accepted 14 March 2019; Published 1 April 2019 Academic Editor: Flor M. Munoz Copyright © 2019 Jodie Dionne-Odom et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Sexually transmitted infections (STIs) are associated with adverse birth outcomes. Current prenatal STI screening guidelines defne “risk” without explicit consideration of HIV status. Our objective was to test the hypothesis that HIV status is associated with bacterial STI in pregnant women. Methods. We designed a retrospective cohort study to identify pregnant women with HIV who delivered at our facility during 2000-2014. HIV+ women were compared to HIV- women with matching by year of delivery. Logistic regression was used to model adjusted odds of prevalent and incident STI. Prevalent STI was defned as chlamydia (CT), gonorrhea (GC), syphilis, or trichomoniasis detected on an initial prenatal screening test and incident STI as a newly positive result following a negative prenatal test. Results. Te cohort included 432 women, 210 HIV+ and 222 HIV-. Most pregnant women were screened for STI (92% of HIV+ women and 74% of HIV- women). STI rates were high and particularly elevated in HIV+ women: 29% vs 18% (p=0.02), for prevalent STI and 11% vs 2% (p<0.001) for incident STI. Risk factors for prevalent STI were as follows: HIV status (aOR 3.0, CI: 1.4-6.4), Black race (aOR 2.7, 95% CI: 1.1-6.6), and more recent delivery (2007-2014 compared to 2000-2006) (aOR 2.3, CI: 1.1-4.7). HIV status was an independent risk factor for incident STI (aOR 7.2, CI: 2.1-25.0). Conclusion. Pregnant women who delivered in our center had high STI rates. Since HIV infection was independently associated with prevalent and incident STI, prenatal screening guidelines may need to incorporate HIV status as a high-risk group for repeat testing. 1. Introduction More than 2 million cases of sexually transmitted infections (STI) in the United States were reported to the U.S. Centers for Disease Control (CDC) in 2017 [1]. Young adults are disproportionately impacted by STI, with important implica- tions for women of reproductive age. Congenital syphilis rates increased 153% since 2013 to 23 cases per 100,000 live births as primary and secondary syphilis rates rise in women [1]. STI and HIV rates are elevated in the Southeastern region [2, 3]. Pregnancy desires in women living with HIV are similar to the general population and successful Prevention of Mother to Child Transmission (MTCT) interventions have reduced vertical HIV transmission rates from 25% to <1% [4, 5]. Te most common and curable STIs in pregnancy are caused by Chlamydia trachomatis (CT), Neisseria gon- orrhoeae (GC), Treponema pallidum (syphilis), and Tri- chomonas vaginalis (TV). Independently, both pregnancy and HIV infection can increase susceptibility to infection. In pregnancy, this increased susceptibility to STI has been attributed to various factors: anatomic (cervical ectropion), immunologic (reduction in humoral and cell-mediated Hindawi Infectious Diseases in Obstetrics and Gynecology Volume 2019, Article ID 6584101, 8 pages https://doi.org/10.1155/2019/6584101