Heterosexual transmission of HIV-1 among employees and their spouses at two large businesses in Zaire.
To better understand the reasons why up to 80% of all HIV-1 infections in Zaire, but less than 5% in North America and Europe, are acquired through heterosexual transmission, and to assess the impact of HIV-1 infection on a large urban African workforce, we enrolled 7068 male employees, 416 female employees and 4548 female spouses of employees at two large Kinshasa businesses (a textile factory and a commercial bank) in a prospective study of HIV-1 infection. The HIV-1 seroprevalence rate was higher in male employees (5.8%) and their spouses (5.7%) at the bank than among male employees (2.8%) and their spouses (3.3%) at the textile factory. At both businesses HIV-1 seroprevalence was higher among employees in managerial positions (5.0%) than among workers in lower-level positions (3.0%; P less than 0.0001). In a multivariate analysis of male employees, receipt of a transfusion, a history of genital ulcer disease, working at the bank, urethritis, or being divorced or separated were independently associated with HIV-1 infection. During 1987 and 1988, AIDS was the most common cause of death among recently employed workers, accounting for 20 and 24% of all deaths at the textile factory and the commercial bank, respectively. The HIV-1 seroprevalence rate was higher among female workers (7.7%) than among the spouses of male workers (3.9%; P = 0.001). In multivariate analysis of the wives of workers, having an HIV-1-seropositive spouse, receipt of a blood transfusion, or a history of genital ulcer disease were independently associated with HIV-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)
Ryder
R W
RW
Project SIDA, Department of Public Health, Kinshasa, Zaire.
Ndilu
M
M
Hassig
S E
SE
Kamenga
M
M
Sequeira
D
D
Kashamuka
M
M
Francis
H
H
Behets
F
F
Colebunders
R L
RL
Dopagne
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality / Q000635:transmission*; D000328:Adult; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D009786:Occupational Health Services; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D014505:Urban Population