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.
Kjetland
Eyrun F
EF
Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevaal University Hospital, Oslo, Norway. e.f.kjetland@medisin.uio.no
Ndhlovu
Patricia D
PD
Gomo
Exenevia
E
Mduluza
Takafira
T
Midzi
Nicholas
N
Gwanzura
Lovemore
L
Mason
Peter R
PR
Sandvik
Leiv
L
Friis
Henrik
H
Gundersen
Svein Gunnar
SG
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