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Reproductive tract infections and the risk of HIV among women in Moshi, Tanzania

Authors

  • Sia E. Msuya,

    1. From the Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway,
    2. Kilimanjaro Christian Medical Center, Moshi, Tanzania, and
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  • Elizabeth Mbizvo,

    1. From the Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway,
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  • Babill Stray-Pedersen,

    1. Department of Obstetric and Gynecology and Epidemiology Center, The National Hospital, University of Oslo, Oslo, Norway
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  • Johanne Sundby,

    1. From the Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway,
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  • Noel E. Sam,

    1. Kilimanjaro Christian Medical Center, Moshi, Tanzania, and
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  • Akhtar Hussain

    1. From the Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway,
    2. Department of Obstetric and Gynecology and Epidemiology Center, The National Hospital, University of Oslo, Oslo, Norway
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Address for correspondence:
Dr Sia E. Msuya
PO Box 8418
Moshi
Tanzania
e-mail: siamsuya@hotmail.com

Abstract

Objectives.  The objectives of the study were to determine the prevalence of HIV and reproductive tract infections (RTIs); to compare the occurrence of RTIs among HIV-infected and non-infected women; and to assess the association of HIV with RTIs and behavioral factors among women aged 15–49 years.

Methods.  A cross-sectional study was conducted in late 1999 among 382 consenting women attending three primary healthcare clinics. They were interviewed and screened for HIV-1 and RTIs.

Results.  The prevalence of HIV-1 was 11.5%. Sixty-four percent of the women had one ongoing treatable RTI. Endogenous and sexually transmitted RTIs were higher in HIV-positive than negative women and 84% of the HIV seropositive women were co-infected with one treatable RTI. HIV was significantly associated with cervicitis (chlamydial or gonococcal) [OR = 3.2 (CI 1.1–13.2)], HSV-2 [OR = 2.6 (CI 1.3–5.1)], bacterial vaginosis [OR = 1.9 (CI 1.1–4.1)], genital warts [OR = 4.8 (CI 1.1–22.2)], and presence of vaginal discharge [OR = 2.7 (CI 1.3–5.2)]. Having more than one lifetime sexual partner, a history of infant mortality or a partner who had other wives or resided away from home > 6 months, were risk factors for HIV infection.

Conclusion.  HIV-1 and RTIs are a major public health problem among women in this population. Integration of routine screening and treatment of RTIs in the reproductive health clinics will be an important strategy to combat HIV in the area. Further, innovative behavior interventions targeting both men and women, preferably as couples are needed.

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