Association between genital schistosomiasis and HIV in rural Zimbabwean women.
OBJECTIVE
To determine the association between female genital Schistosoma haematobium infection and HIV.


METHODS
A cross-sectional study with a 1-year follow-up. Gynecological and laboratory investigations were performed for S. haematobium and HIV. Sexually transmitted infections, demographic and urogenital history were analysed as confounders. The participants were 527 sexually active, non-pregnant, non-menopausal women between the ages of 20 and 49 years. The setting was a rural Zimbabwean community where S. haematobium related lesions were found in 46% of the women, HIV in 29% and herpes simplex type- 2 (HSV-2) in 65%.


RESULTS
In permanent residents (>3 years residency), HIV was found in 41% (29/70) of women with laboratory proven genital schistosomiasis as opposed to 26% HIV positive (96/375) in the schistosomal ova negative group [odds ratio (OR), 2.1; 95% confidence interval (CI), 1.2-3.5; P = 0.008. In multivariate analysis S. haematobium infection of the genital mucosa was significantly associated with HIV seropositivity (adjusted OR, 2.9; 95% CI, 1.11-7.5; P = 0.030). All seven women who became HIV positive during the study period (seroincidence 3.1%) had signs of S. haematobium at baseline. In accordance with other studies HIV was significantly associated with HSV-2 (OR, 3.0; 95% CI, 1.7-5.3; P < 0.001), syphilis and human papillomavirus. The highest HIV prevalence (45%) was found in the 25-29 years age group.


CONCLUSIONS
Women with genital schistosomiasis had an almost three-fold risk of having HIV in this rural Zimbabwean community. Prospective studies are needed to confirm the association.
Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevaal University Hospital, Oslo, Norway. e.f.kjetland@medisin.uio.no
Eyrun F
EF
Kjetland
Patricia D
PD
Ndhlovu
Exenevia
E
Gomo
Takafira
T
Mduluza
Nicholas
N
Midzi
Lovemore
L
Gwanzura
Peter R
PR
Mason
Leiv
L
Sandvik
Henrik
H
Friis
Svein Gunnar
SG
Gundersen
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000453:epidemiology; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D012553:Schistosomiasis haematobia / Q000150:complications* / Q000453:epidemiology; D015030:Zimbabwe / Q000453:epidemiology