A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results.

ABSTRACT

PIP: To measure the impact of a sexually transmitted disease (STD) treatment program on the incidence of human immunodeficiency virus (HIV) in Zimbabwe's Mwanza Region, a pre-intervention baseline survey was conducted. Included in the survey were approximately 1000 randomly selected adults from each of the six intervention communities (defined as the population served by a health center and its satellite dispensaries) and six matched comparison communities. Overall HIV seroprevalence was 4.1% (3.7% in men and 4.4% in women), with a range of 1.6-8.6% and no significant differences between intervention and control communities. Peak prevalences for both sexes were found in the 25-34 year age groups and in roadside communities. The following factors were associated with an increased likelihood of HIV infection: separation, divorce, or widowhood; multiple injections in the preceding year; educational achievement of at least Standard 4; travel out of the district in the prior year; history of genital ulcers or discharge; and past or present infection with syphilis. HIV prevalence was significantly higher in circumcised men, but not when adjustment was made for other risk factors. Syphilis prevalence ranged from a low of 4.2% in island communities to a high of 11.1% in roadside communities. The baseline survey indicates that intervention and control populations are generally comparable, and that the goal of locating a study area with a relatively low incidence of HIV and high rates of other STDs has been achieved.