title: Prevalence of HIV and Chlamydia trachomatis infection in 15--19-year olds in rural Tanzania.
abstract: OBJECTIVE
  To estimate the prevalence of HIV and Chlamydia trachomatis (CT) infections amongst adolescents in rural Mwanza Region, Tanzania and their association with demographic variables.
  
  
  METHODS
  Population-based cross-sectional survey.
  
  
  METHODS
  All 15--19-year olds living in households selected by random cluster sampling were invited to participate. After interview, urine was tested for HIV and CT.
  
  
  RESULTS
  9445 15--19-year olds were enrolled. HIV prevalence was 0.6% (95% CI: 0.4--0.8%) in males and 2.4% (95% CI: 2.0--2.8%) in females, and increased steeply with age (trend: P < 0.006 and P < 0.001, respectively). After adjustment for age, risk of HIV infection was significantly associated with female sex (OR=4.3), never having been to primary school in males (OR=2.7), and current symptoms of genital discharge (OR=2.3) or genital ulcer (OR=5.3) in females. The prevalence of CT was 1.0% (95% CI: 0.8--1.4%) in males and 2.4% (95% CI: 2.0-2.9%) in females. After adjustment for age, CT infection was associated with female sex (OR=2.4), reported current symptoms of STD (males OR=2.5, females OR=1.9) and positive leucocyte esterase (LE) test (males OR=3.1, females OR=2.6). Eighty-two percent of males and 79% of females with CT were asymptomatic. There was no association between CT and HIV infection in either sex.
  
  
  CONCLUSIONS
  There is a high prevalence of HIV and CT amongst adolescents, especially young women, in this rural population, highlighting the need for effective interventions to improve adolescent reproductive health. The high rates of asymptomatic infection imply that innovative strategies are needed to reach and treat young people with STD.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK. angela.obasi@lshtm.ac.uk
authors.forename: A I
authors.initials: AI
authors.lastname: Obasi
authors.forename: R
authors.initials: R
authors.lastname: Balira
authors.forename: J
authors.initials: J
authors.lastname: Todd
authors.forename: D A
authors.initials: DA
authors.lastname: Ross
authors.forename: J
authors.initials: J
authors.lastname: Changalucha
authors.forename: F
authors.initials: F
authors.lastname: Mosha
authors.forename: H
authors.initials: H
authors.lastname: Grosskurth
authors.forename: R
authors.initials: R
authors.lastname: Peeling
authors.forename: D C
authors.initials: DC
authors.lastname: Mabey
authors.forename: R J
authors.initials: RJ
authors.lastname: Hayes
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000453:epidemiology*; D002692:Chlamydia trachomatis; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012423:Rural Health; D017678:Sex Distribution; D013636:Tanzania / Q000453:epidemiology