A rural HIV epidemic in Zimbabwe? Findings from a population-based survey

The aim of the study was to use population-based data from 689 adults to de scribe the socio-demographic, behavioural and biomedical correlates of HIV infection and aid identification of effective HIV control strategies for ru ral Zimbabwe. Dried blood spot and urine samples were collected for HIV and sexually transmitted disease (STD) testing and participants were interview ed on socio-demographic characteristics, sexual behaviour and experience of STD symptoms. HIV seroprevalence was 23.3% and was higher in females, divo rcees, widows, working men, estate residents, and respondents reporting his tories of STD symptoms. Female HIV seroprevalence rises sharply at ages 16- 25. A third of sexually-active adults had experienced STD-associated sympto ms but there were delays in seeking treatment. Herpes simplex virus type 2 (HSV-2) and Trichomonas vaginalis are more common causes than syphilis, gon orrhoea, and chlamydia, and are strongly associated with HIV infection. Loc al programmes promoting safer sexual behaviour and fast and effective STD t reatment among young women, divorcees and working men could reduce the exte nsive HIV transmission in rural communities.