Reproductive tract infections and the risk of HIV among women in Moshi, Tanzania.
OBJECTIVE
The objectives of the study were to determine the prevalence of HIV and reproductive tract infections (RTIs); to compare the occurrence of RTIs among HIV-infected and non-infected women; and to assess the association of HIV with RTIs and behavioral factors among women aged 15-49 years.


METHODS
A cross-sectional study was conducted in late 1999 among 382 consenting women attending three primary healthcare clinics. They were interviewed and screened for HIV-1 and RTIs.


RESULTS
The prevalence of HIV-1 was 11.5%. Sixty-four percent of the women had one ongoing treatable RTI. Endogenous and sexually transmitted RTIs were higher in HIV-positive than negative women and 84% of the HIV seropositive women were co-infected with one treatable RTI. HIV was significantly associated with cervicitis (chlamydial or gonococcal) [OR = 3.2 (CI 1.1-13.2)], HSV-2 [OR = 2.6 (CI 1.3-5.1)], bacterial vaginosis [OR = 1.9 (CI 1.1-4.1)], genital warts [OR = 4.8 (CI 1.1-22.2)], and presence of vaginal discharge [OR = 2.7 (CI 1.3-5.2)]. Having more than one lifetime sexual partner, a history of infant mortality or a partner who had other wives or resided away from home > 6 months, were risk factors for HIV infection.


CONCLUSIONS
HIV-1 and RTIs are a major public health problem among women in this population. Integration of routine screening and treatment of RTIs in the reproductive health clinics will be an important strategy to combat HIV in the area. Further, innovative behavior interventions targeting both men and women, preferably as couples are needed.
Msuya
Sia E
SE
Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway. siamsuya@hotmail.com
Mbizvo
Elizabeth
E
Stray-Pedersen
Babill
B
Sundby
Johanne
J
Sam
Noel E
NE
Hussain
Akhtar
A
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013636:Tanzania / Q000453:epidemiology