Literature DB >> 7576329

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

H Grosskurth1, F Mosha, J Todd, K Senkoro, J Newell, A Klokke, J Changalucha, B West, P Mayaud, A Gavyole.   

Abstract

OBJECTIVES: To determine baseline HIV prevalence in a trial of improved sexually transmitted disease (STD) treatment, and to investigate risk factors for HIV. To assess comparability of intervention and comparison communities with respect to HIV/STD prevalence and risk factors. To assess adequacy of sample size.
SETTING: Twelve communities in Mwanza Region, Tanzania: one matched pair of roadside communities, four pairs of rural communities, and one pair of island communities. One community from each pair was randomly allocated to receive the STD intervention following the baseline survey.
METHODS: Approximately 1000 adults aged 15-54 years were randomly sampled from each community. Subjects were interviewed, and HIV and syphilis serology performed. Men with a positive leucocyte esterase dipstick test on urine, or reporting a current STD, were tested for urethral infections.
RESULTS: A total of 12,534 adults were enrolled. Baseline HIV prevalences were 7.7% (roadside), 3.8% (rural) and 1.8% (islands). Associations were observed with marital status, injections, education, travel, history of STD and syphilis serology. Prevalence was higher in circumcised men, but not significantly after adjusting for confounders. Intervention and comparison communities were similar in the prevalence of HIV (3.8 versus 4.4%), active syphilis (8.7 versus 8.2%), and most recorded risk factors. Within-pair variability in HIV prevalence was close to the value assumed for sample size calculations.
CONCLUSIONS: The trial cohort was successfully established. Comparability of intervention and comparison communities at baseline was confirmed for most factors. Matching appears to have achieved a trial of adequate sample size. The apparent lack of a protective effect of male circumcision contrasts with other studies in Africa.

Entities:  

Keywords:  Africa; Africa South Of The Sahara; Baseline Surveys; Biology; Community Health Services; Delivery Of Health Care; Demographic Factors; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Health; Health Services; Health Services Evaluation; Hiv Infections; Infections; Measurement; Organization And Administration; Population; Population Characteristics; Prevalence; Primary Health Care; Program Evaluation; Programs; Reproductive Tract Infections; Research Methodology; Risk Factors; Rural Population; Sampling Studies; Sexually Transmitted Diseases; Studies; Study Design; Surveys; Tanzania; Treatment; Viral Diseases

Mesh:

Year:  1995        PMID: 7576329     DOI: 10.1097/00002030-199508000-00015

Source DB:  PubMed          Journal:  AIDS        ISSN: 0269-9370            Impact factor:   4.177


  29 in total

1.  Efforts to Control Sexually Transmitted Diseases As a Means to Limit HIV Transmission: Pros and Cons.

Authors:  Gina Dallabetta; Madaline Feinberg
Journal:  Curr Infect Dis Rep       Date:  2001-04       Impact factor: 3.725

Review 2.  Immunological functions of the human prepuce.

Authors:  P M Fleiss; F M Hodges; R S Van Howe
Journal:  Sex Transm Infect       Date:  1998-10       Impact factor: 3.519

3.  The coreceptor mutation CCR5Delta32 influences the dynamics of HIV epidemics and is selected for by HIV.

Authors:  A D Sullivan; J Wigginton; D Kirschner
Journal:  Proc Natl Acad Sci U S A       Date:  2001-08-21       Impact factor: 11.205

4.  More on the cohort-component model of population projection in the context of HIV/AIDS: A Leslie matrix representation and new estimates.

Authors:  Jason R Thomas; Samuel J Clark
Journal:  Demogr Res       Date:  2011-07-05

5.  HIV and population dynamics: a general model and maximum-likelihood standards for east Africa.

Authors:  Patrick Heuveline
Journal:  Demography       Date:  2003-05

6.  Evaluating Public Health Interventions: 2. Stepping Up to Routine Public Health Evaluation With the Stepped Wedge Design.

Authors:  Donna Spiegelman
Journal:  Am J Public Health       Date:  2016-03       Impact factor: 9.308

Review 7.  Randomised trials of STD treatment for HIV prevention: report of an international workshop. HIV/STD Trials Workshop Group.

Authors:  R Hayes; M Wawer; R Gray; J Whitworth; H Grosskurth; D Mabey
Journal:  Genitourin Med       Date:  1997-12

8.  Risk factors for active syphilis and TPHA seroconversion in a rural African population.

Authors:  J Todd; K Munguti; H Grosskurth; J Mngara; J Changalucha; P Mayaud; F Mosha; A Gavyole; D Mabey; R Hayes
Journal:  Sex Transm Infect       Date:  2001-02       Impact factor: 3.519

9.  Sexual health screening among racially/ethnically diverse young gay, bisexual, and other men who have sex with men.

Authors:  Daniel E Siconolfi; Farzana Kapadia; Perry N Halkitis; Robert W Moeller; Erik D Storholm; Staci C Barton; Todd M Solomon; Donovan Jones
Journal:  J Adolesc Health       Date:  2012-12-01       Impact factor: 5.012

10.  Seroprevalence and incidence of genital ulcer infections in a rural Ugandan population.

Authors:  A Kamali; A J Nunn; D W Mulder; E Van Dyck; J G Dobbins; J A Whitworth
Journal:  Sex Transm Infect       Date:  1999-04       Impact factor: 3.519

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