HIV and Reproductive Tract Infections in a Total Village Population in Rural Kilimanjaro, Tanzania

Abstract

The aim of this study was to determine the prevalence of HIV infection, other sexually transmitted diseases (STDs), and biological risk factors associated with HIV infection in a rural population in Tanzania. A population-based study of a village population was carried out from July 1991 through January 1992. A total of 3,239 people (83.7%) participated in an HIV serosurvey. The total HIV prevalence was 0.7 and 1.9% among males and females, respectively (odds ratio, OR = 2.5; 95% confidence interval, CI: 1.2-5.1), and 4.3% in women and 1.6% in men in participants aged 15 to 44 (OR = 2.6; CI: 1.2-5.8). The same age group was interviewed and offered screening for STDs. Trichomonas vaginalis vaginitis (24.7%) was the most common reproductive tract infection (RTI); 10.3% of women were infertile and 10.6% suffered from pelvic inflammatory disease (PID). Comparing women and men, we found that 2.2 versus 20.4% had been treated for genital discharge (OR = 12.6; CI: 7.1-22.5); 2.6 versus 1.2% suffered from active syphilis (OR = 1.5; CI: 0.9-2.3); 6.9 versus 9.6% had chlamydial infection; and 46.9 versus 14.6% had an ongoing RTI/STD (OR = 5.0; CI: 3.6-6.9). A significant association was found between HIV infection and STD cases (in women) and between HIV infection and a history of STDs (in men). The heavy burden of untreated RTIs in females calls for a more gender-specific approach to HIV and STD prevention.

A Community-Based Study of Risk Factors for Trichomonas vaginalis Infection Among Women and Their Male Partners in Moshi Urban District, Northern Tanzania

“…The prevalence of T. vaginalis was 10.7% in women and 6.3% in men, indicating that it was the most prevalent nonviral STI and a major public health problem in this population. Other community-based studies conducted in Tanzania have estimated T. vaginalis prevalence at greater than 20% among women 12,13 and 11% in men. 14 Vol.…”

Female Genital Schistosomiasis of the Lower Genital Tract: Prevalence and Disease‐Associated Morbidity in Northern Tanzania

“…We do not have information about the HIV prevalence in the study sites; however, a study in a rural area in the same district found an HIV prevalence of 4.8% in women aged 15-44 years [12]. Since cervical epithelium is thought to be the likely virus entry point [13], the impairment of the physical barrier of the cervical epithelium due to epithelial swelling and disrupted epithelium seen in the FGS cases might enable the entry or exit of HIV.…”

Trichomoniasis

“…The World Health Organization has estimated that this infection accounts for almost half of all curable infections worldwide (17). Various studies of African populations have reported the prevalence of vaginal trichomoniasis to be between 11 and 25% (53,57,61). Laga et al reported an incidence of 38% during a 4-month exposure interval among HIV-infected women in Zaire (57).…”