Multi-Target Molecular Detection of Sexually Transmitted Infections in Women Living with HIV in Northeastern Brazil

Co-infection by human papillomavirus (HPV) and human immunodeficiency virus (HIV) facilitates cervical carcinogenesis, and additional cofactors such as other sexually transmitted infections (STI) further aggravate this scenario. This study aimed to validate a molecular detection strategy for <i>Chlamydia trachomatis</i>, <i>Trichomonas vaginalis</i> and <i>Neisseria gonorrhoeae</i> and to assess the association of these infections with cervical lesions in HPV-positive women living with HIV in Northeastern Brazil. In total, 155 samples were collected from CRIST/AIDS. After microorganism detection by conventional PCR, a multiplex PCR was standardized and validated. A prevalence of 9.03% was observed for <i>C. trachomatis</i> and 6.45% for <i>T. vaginalis</i>, with 0.64% co-infection. In addition, infection with both STIs showed a prevalence of 0.64%. Among HPV-positive women, high-risk genotypes accounted for 70.9% of cases, with HPV-16 being the most prevalent (35.5%). Overall, 18.2% of women presented cervical lesions, and 13.2% of those with co-detection of <i>C. trachomatis</i> and <i>T. vaginalis</i> were associated with high-grade squamous intraepithelial lesions (HSIL). These findings highlight the clinical relevance of screening for multiple STIs in HPV-positive women living with HIV and support the incorporation of multiplex molecular testing into public health strategies to improve early detection and targeted management.