HIV and reproductive tract infections in a total village population in rural Kilimanjaro, Tanzania: women at increased risk.

The aim of this study was to determine the prevalence of HIV infection, other sexually transmitted diseases (STDs), and biological risk factors associated with HIV infection in a rural population in Tanzania. A population-based study of a village population was carried out from July 1991 through January 1992. A total of 3,239 people (83.7%) participated in an HIV serosurvey. The total HIV prevalence was 0.7 and 1.9% among males and females, respectively (odds ratio, OR = 2.5; 95% confidence interval, CI: 1.2-5.1), and 4.3% in women and 1.6% in men in participants aged 15 to 44 (OR = 2.6; CI: 1.2-5.8). The same age group was interviewed and offered screening for STDs. Trichomonas vaginalis vaginitis (24.7%) was the most common reproductive tract infection (RTI); 10.3% of women were infertile and 10.6% suffered from pelvic inflammatory disease (PID). Comparing women and men, we found that 2.2 versus 20.4% had been treated for genital discharge (OR = 12.6; CI: 7.1-22.5); 2.6 versus 1.2% suffered from active syphilis (OR = 1.5; CI: 0.9-2.3); 6.9 versus 9.6% had chlamydial infection; and 46.9 versus 14.6% had an ongoing RTI/STD (OR = 5.0; CI: 3.6-6.9). A significant association was found between HIV infection and STD cases (in women) and between HIV infection and a history of STDs (in men). The heavy burden of untreated RTIs in females calls for a more gender-specific approach to HIV and STD prevention.