High potential of escalating HIV transmission in a low prevalence setting in rural Tanzania

Abstract

Background: Previous surveillance among antenatal clinic (ANC) attendees within the remote rural Manyara and Singida regions in Tanzania identified an imminent but still, relatively low HIV epidemic. We conducted a population-based HIV study to identify risk factors and validate the representativeness of ANC-based estimates.Methods: Using a two-stage cluster sampling approach, we enrolled and then interviewed and collected saliva samples from 1,698 adults aged 15-49 years between December 2003 and May 2004. We anonymously tested saliva samples for IgG antibodies against HIV using Bionor HIV-1&2 assays ® . Risk factors for HIV infection were analysed by multivariate logistic regression using the rural population of the two regions as a standard. Results:The prevalence of HIV in the general population was 1.8% (95%CI: 1.1-2.4), closely matching the ANC-based estimate (2.0%, 95% CI: 1.3-3.0). The female to male prevalence ratio was 0.8 (95%CI 0.4-1.7). HIV was associated with being a resident in a fishing community, and having recently moved into the area. Multiple sexual partners increased likelihood of HIV infection by 4.2 times (95% CI; 1.2-15.4) for men. In women, use of contraceptives other than condoms was associated with HIV infection (OR 6.5, 95% CI; 1.7-25.5), while most of the population (78%) have never used condoms. Conclusion:The HIV prevalence from the general population was comparable to that of pregnant women attending antenatal clinics. The revealed patterns of sexual risk behaviours, for example, close to 50% of men having multiple partners and 78% of the population have never used a condom; it is likely that HIV infection will rapidly escalate. Immediate and effective preventive efforts that consider the socio-cultural contexts are necessary to reduce the spread of the infection.

Aetiologies of altered states of consciousness: A prospective hospital-based study in a series of 464 patients of northern Tanzania

“…It has to be emphasized that testing for HIV was not performed in the patients. However, after HIV tests became available, HIV/AIDS was shown to be of low prevalence in the study area [16].…”

HIV-1, HSV-2 and syphilis among pregnant women in a rural area of Tanzania: Prevalence and risk factors

“…Despite the generalised, stable HIV epidemic in Tanzania, the epidemiological patterns of STIs have shown regional variations on the level and magnitude, largely influenced by cultural, economical political and social factors. [ 14 , 17 ]. The prevalence of HSV-2 was significantly higher in all clinics compared to Basotu clinic but this village reportedly, had the highest HIV prevalence [ 17 ].…”

“…The HIV prevalence (2%) in Manyara region by the end of 2004, matched with the estimate pregnant women attending local clinics within rural Manyara and Singida regions [ 14 , 16 ]. In the antenatal group, young women (15–19 years) presented with the highest prevalence (3.0%) and in the general population, men aged 35–49 years [ 16 , 17 ]. In comparison with other regions in Tanzania, the HIV prevalence is still low [ 14 ].…”

Association between Taenia solium infection and HIV/AIDS in northern Tanzania: a matched cross sectional-study

“…In the same report, prevalence proportions of 1.5% for the Manyara region and 3.3% for the Singida region were estimated. It is believed that HIV emerged in these regions relatively late (mid 1990s), but has steadily increased ever since and already reached the country’s average in some districts like Babati [39]. …”