CONTROL OF SEXUALLY-TRANSMITTED DISEASES IN HAITI - RESULTS AND IMPLICATIONS OF A BASE-LINE STUDY AMONG PREGNANT-WOMEN LIVING IN CITE-SOLEIL SHANTYTOWNS

Women attending Haitian slum-based antenatal clinics were evaluated fo r sexually transmitted diseases (STDs): 110 (11%) of 996 were syphilis seroreactive, 313 (35%) of 903 had trichomoniasis, 110 (12%) of 897 h ad gonococcal or chlamydial cervical infection (or both), and 418 (47% ) of 891 had at least one STD. Syphilis seroreactivity was associated with illiteracy (P = .007), lower socioeconomic status (P < .001), and a history of spontaneous abortion (P = .02). Of 663 evaluated sera, 5 6 (8%) had human immunodeficiency virus (HIV) antibodies. In multivari ate analysis, positive HIV serostatus was associated with syphilis ser oreactivity (P = .006), partner's unemployment (P = .002), and history of a previous sex partner (P = .04). Risk factors for gonococcal or c hlamydial cervical infection were evaluated. Clinical assessment of ce rvical discharge, a World Health Organization algorithm, and a decisio n model based on local risk factors were 64%, 77%, and 89% sensitive, respectively, and 44%, 38%, and 43% specific, respectively, for predic ting cervical infection. Alternative treatment approaches should be va lidated while waiting for affordable, simple, rapid, and accurate labo ratory diagnostic tests for gonococcal and chlamydial cervical infecti ons.