Risk factors for cervical squamous intraepithelial lesions among HIV-1 seropositive women in Dar es Salaam, Tanzania.
OBJECTIVE
To determine the prevalence and risk factors for cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Dar es Salaam, Tanzania.


METHODS
Between July 1996 and December 1997 we interviewed 691 HIV-infected women to obtain information about risk factors for SIL. Cervical smears and samples for lymphocyte subsets and sexually transmitted diseases (STD) diagnosis were collected.


RESULTS
The prevalence of SIL was 2.9% (20/686) (95% CI = 1.7-4.2%). Eleven women had low-grade SIL while nine women had high-grade SIL. The number of lifetime sexual partners and live births was associated with a marginally non-significant increased risk of SIL. The risk of SIL was significantly increased among women with CD4+ cell count < 200/mm3 (multivariate odds ratio (OR) = 6.15, 95% CI = 1.19-41.37) and decreased by 68% for each 5-cm increase in mid-upper arm circumference (multivariate OR = 0.32, 95% CI = 0.10-0.93).


CONCLUSIONS
HIV-related immunosuppression and wasting and long-term sexual behavior were the major determinants of SIL in this population. Federation of Gynecology and Obstetrics.
Kapiga
S H
SH
Department of Epidemiology and Biostatistics, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Msamanga
G I
GI
Spiegelman
D
D
Mwakyoma
H
H
Fawzi
W W
WW
Hunter
D J
DJ
D000293:Adolescent; D000328:Adult; D005260:Female; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D018655:Lymphocyte Count; D008875:Middle Aged; D012307:Risk Factors; D016176:T-Lymphocyte Subsets; D013636:Tanzania / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*