Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study.
AIDS
; 11(2): 237-48, 1997 Feb.
Article
in En
| MEDLINE
| ID: mdl-9030372
ABSTRACT
PIP: In a baseline survey a cohort of 12,537 adults was enrolled, interviewed, and examined between November 1991 and December 1992 in the Mwanza Region of Tanzania using random cluster sampling. The study itself took place in May and June of 1993, and it consisted of 338 cases (149 men and 189 women) and 1078 controls (504 men and 574 women). The remainder of the analysis of men was restricted to the 149 cases and 394 controls 20-54 years old. The blood samples from consenting adults were tested for HIV antibodies by enzyme-linked immunosorbent assay (ELISA). A significantly higher HIV prevalence was found among men and women not currently employed in farming (men: odds ratio [OR] 2.08; women: OR 3.65), women who had traveled (OR 3.27), educated women (OR 4.51), and widowed/divorced people compared with those currently married (men: OR 3.10; women: OR 3.54). Two spouse-related factors were significantly associated with HIV even after adjustment for the sexual behavior of the index case: HIV was more prevalent in men with younger spouses (p = 0.020 for trend) and in women married to men currently employed in manual work, office work, or business (OR 2.20). In women only blood transfusions were associated with a 2-fold increased prevalence of HIV (OR 2.40), but only a small population-attributable fraction (4%). There was an increased HIV prevalence associated with increasing numbers of injections, even after adjustment for confounders. The reported number of lifetime sexual partners was significantly associated with HIV infection (women: OR 7.33 if or= 10 lifetime partners compared with or= 1; men: OR 4.35 for or= 50 compared with or= 1). After adjustment for confounders, male circumcision was associated with a lower HIV prevalence (OR 0.65; p = 0.11). Most HIV infections occurred through sexual transmission, although some were attributable to nonsterile injections. Since the large number of sexual partners was a major risk factor, intervention strategies should promote the reduction of partners and the use of condoms.
Key words
Africa; Africa South Of The Sahara; Behavior; Correlation Studies; Demographic Factors; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Hiv Infections--prevention and control; Multiple Partners; Population; Population Characteristics; Research Methodology; Risk Reduction Behavior; Rural Population; Sex Behavior; Sexual Partners; Statistical Studies; Studies; Tanzania; Viral Diseases
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Rural Population
/
Sexual Behavior
/
HIV Infections
Type of study:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Africa
Language:
En
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
1997
Document type:
Article
Affiliation country: