title: Practising obstetrics and gynaecology in areas with a high prevalence of HIV infection.
abstract: What is it like to practise obstetrics and gynaecology in a country with a high prevalence of HIV infection? My experience relates especially to Zimbabwe, but the same factors apply equally well to Zambia, Zaire, Uganda, Kenya, Tanzania, Malawi, and Mozambique. Within a population of 11 million in Zimbabwe, at least 1 million are HIV positive according to the official figures. AIDS often means "home-based care"; the nearest clinic or hospital, which has very little to offer, may be 3 hours away by wheelbarrow. Many patients who die with chronic diarrhoea lack a piped water supply nearby, an indoor toilet, or even a waterproof sheet. Every year in Zimbabwe there are 120,000 confinements of HIV-positive women compared with 7000 HIV-positive pregnancies in the USA. Transmission of the virus in Africa is mainly heterosexual and vertical, although blood transfusion still plays a part. Intravenous drug use is not a problem but alcohol is, by way of promoting risky behaviour. A secondary epidemic of tuberculosis (TB) (also among HIV-negative persons) adds to the difficulties in sub-Saharan Africa.
authors.forename: D A
authors.initials: DA
authors.lastname: Verkuyl
mesh_terms: D000293:Adolescent; D000328:Adult; D016358:Contact Tracing; D003267:Contraception; D005193:Family Planning Services; D005260:Female; D006176:Gynecology; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D009774:Obstetrics; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies