Sexual behaviour among youths at high risk for HIV-1 infection in Dar es Salaam, Tanzania

Objectives: To investigate sex specific sexual behaviour in youths visiting a youth clinic for sexual and reproductive health in Dar es Saalam. Methods: A questionnaire was administered to a random sample of youths betw een 10 and 24 years of age attending the youth health clinic in Dar es Saal am. The clinical investigation included testing for syphilis and HIV-1 anti bodies Results: 1423 youths attended the clinic between September 1997 and August 1998. The study population comprised 213 (53.5%) males and 185 (46.5%) fema les. 97 (24.4%) were below 20 years. The mean age at coitarche was 16.5 and 17.0 years of age for males and females, respectively. The coitarche was i nvoluntary in 15 females (8.6%). 49.5% males reported more than five lifeti me partners compared with 14.1% for females (p <0.0001). Males reported rec ent partners to be 2.5 years younger, while females reported them to be 5.0 years older. No contraceptive use was reported by 29.7% of the males and 4 0.3% of females. 52.7% females had been pregnant and 26 (14.1%) reported in duced abortions. Genital discharge was found in 69.5% and 73.9% and GUD in 36.6% and 27.1% of males and females respectively. 12 males (5.9%) and 43 f emales (24.6%) were found to be HIV-1 infected. 13.8% of the females with o nly one lifetime partner were HIV-1 infected compared with 40.9% with more than five partners (p=0.028). Conclusions: Many youths in Dar es Salaam engage in sexual behaviours that put them at risk of unwanted pregnancies and STIs including HIV infection. Female youths were more likely to contract HIV infection than males. In Afr ican urban areas youth oriented clinics can have a pivotal role in HIV/STI prevention and control.