HIV-INFECTION AND ASYMPTOMATIC SEXUALLY-TRANSMITTED INFECTIONS IN A RURAL SOUTH-AFRICAN COMMUNITY

The objective was to determine the prevalence of HIV and other sexuall y transmitted infections (STIs) in a rural community. A population-bas ed survey of adults in 110 homesteads was conducted in 1995. A questio nnaire on demographics, sexual practices and history of STDs was admin istered. Neisseria gonorrhoeae and Chlamydia trachomatis infections we re detected using ligase chain reaction (LCR) assay of urine. The sero prevalence of syphilis rapid plasma reagin (RPR) and Treponema pallidu m haemagglutination assay (TPHA) and HIV infection (ELISA) was determi ned. Among 259 subjects the prevalence of HIV was 10.5%, N. gonorrhoea e 4.5%, C. trachomatis 6.1% and active syphilis 8.8%. All infections w ere asymptomatic. Forty per cent of sexually active men had more than one concurrent sexual partner. Only 14% of subjects had ever used cond oms. The STI epidemic is being promoted by high levels of asymptomatic infections, high partner concurrency and low condom use.