HIV AND REPRODUCTIVE-TRACT INFECTIONS IN A TOTAL VILLAGE POPULATION IN RURAL KILIMANJARO, TANZANIA - WOMEN AT INCREASED RISK

The aim of this study was to determine the prevalence of HIV infection , other sexually transmitted diseases (STDs), and biological risk fact ors associated with HIV infection in a rural population in Tanzania. A population-based study of a village population was carried out from J uly 1991 through January 1992. A total of 3,239 people (83.7%) partici pated 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% confi dence interval, CI: 1.2-5.1), and 4.3% in women and 1.6% in men in par ticipants aged 15 to 44 (OR = 2.6; CI: 1.2-5.8). The same age group wa s interviewed and offered screening for STDs. Trichomonas vaginalis va ginitis (24.7%) was the most common reproductive tract infection (RTI) ; 10.3% of women were infertile and 10.6% suffered from pelvic inflamm atory 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% ha d an ongoing RTI/STD (OR = 5.0; CI: 3.6-6.9). A significant associatio n 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 unt reated RTIs in females calls for a more gender-specific approach to HI V and STD prevention.