HIV-INFECTION AND SEXUAL-BEHAVIOR AMONG WOMEN WITH INFERTILITY IN TANZANIA - A HOSPITAL-BASED STUDY

Background. Infertility is common in Africa, but virtually no data exi st on HIV prevalence among infertile women. Mainly anthropological stu dies in Africa have shown that infertile women have higher risks oi ma rital instability and possibly also have more sexual partners than fer tile women. Method. This study was conducted in a hospital in northwes t Tanzania during 1994 and 1995. Women presenting themselves with infe rtility problems io the outpatient clinic were interviewed, examined a nd blood was drawn. Women who came to deliver in the hospital, excludi ng primiparae, were taken as a control group. The analysis was limited to women greater than or equal to 24 years. In total, 154 infertile a nd 259 fertile women were included in the study. Results. HIV prevalen ce was markedly higher among infertile women than among fertile women: 18.2% and 6.6% respectively (adjusted odds ratio [OR] for age, reside nce and occupation 2.7; 95% confidence interval [CI] : 1.4-5.3). Data on past sexual behaviour showed that infertile women had more marital breakdowns, more lifetime sexual partners and a higher level oi exposu re to sexually transmitted diseases (STD). Conclusion. Women with fert ility problems appear to have higher HIV prevalence, which justifies m ore attention for such women in the context oi AIDS programmes. In add ition, caution is needed when using sentinel surveillance data from an tenatal clinics to monitor HIV prevalence.