Changes in the patterns of sexually transmitted infection among South African mineworkers, associated with the emergence of the HIV/AIDS epidemic.
OBJECTIVE
To study temporal changes in the relative prevalence of STI syndromes and the aetiology of genital ulcer disease (GUD) among migrant mineworkers in a goldmining area in South Africa during the period 1992 - 2000 and to explore the epidemiological synergy and interactions between these conventional STIs and the emergence of HIV infection.


METHODS
The records of all STI patients presenting with new episodes of STI seen at a dedicated STI clinic in the Carletonville area, near Johannesburg, between 1992 and 2000 were reviewed and analysed. In addition, crosssectional studies to determine the aetiology of genital ulcerations were conducted.


RESULTS
During the study period, 36 686 new STI episodes were treated at the clinic with a mean annual STI incidence rate of 137.4 per 1 000 miners. The STI incidence remained high throughout the period 1994 - 1999. A total of 35 789 HIV tests were performed during the study period; the overall HIV prevalence was 35.3%. Between 1986 and 1994, the relative prevalence of genital herpes rapidly increased among GUD patients co-infected with HIV: 0% in 1986, 4.7% in 1990 and 20.8% in 1994.


CONCLUSIONS
Syndromic and microbiological surveillance indicates that there was a high incidence of non-herpetic genital ulcerations among miners during the early phase of HIV epidemic. This sustained high incidence of GUDs was followed by a rapid increase in HIV prevalence and changes in the aetiology of the STI syndrome.
Htun
Ye
Y
Sexually Transmitted Infections Reference Centre, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
Radebe
F
F
Fehler
H G
HG
Ballard
R C
RC
D004641:Emigration and Immigration; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008906:Mining; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology