Lifestyle, Hygiene, and Behavioural Risk Factors for Urinary Tract Infections and HIV Among Women in Central Asia

Abstract

Background. Women in Central Asia bear a substantial burden of two distinct infectious conditions: urinary tract infections (UTIs), the most common bacterial infection in women, and HIV, in a region where the epidemic continues to grow. The two have fundamentally different transmission routes and risk factors, yet both are shaped by gendered social and structural determinants.

Objective. To synthesise the lifestyle, hygiene, behavioural, and structural risk factors for UTIs and for HIV among women in Central Asia, treating each condition according to its own biology while examining the shared determinants and the implications for prevention.

Methods. We conducted a structured synthesis of published evidence, prioritising regional surveillance and cohort studies—including the DARMIS-2018 uropathogen study and Central Asian HIV cohorts—alongside UNAIDS regional estimates and the international literature.

Results. For UTIs, lifetime risk in adult women is approximately 40–60%, with hygiene- and lifestyle-related factors (sexual activity, voiding behaviour, contraceptive method, post-menopausal changes) and Escherichia coli predominance (around 75–90% of uncomplicated cases). For HIV, the Eastern Europe and Central Asia region recorded an estimated 140,000 new infections in 2023—a 20% rise since 2010—driven historically by injection drug use and increasingly by sexual transmission; women are most often infected through their own injecting or that of male partners, with HIV prevalence reported as high as 30% among female partners who inject drugs in one Almaty study. The risk factors for the two conditions are largely non-overlapping.

Conclusion. UTIs and HIV in Central Asian women require distinct, biologically appropriate prevention strategies—hygiene, behavioural, and stewardship measures for UTI; harm reduction, condom access, testing, and treatment for HIV—linked by attention to the shared social determinants of women’s vulnerability. Conflating the two, or attributing HIV to hygiene, is both scientifically incorrect and stigmatising.