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  • Title: STD treatment reduces HIV in rural Tanzania.
    Author: Boyles S.
    Journal: AIDS Wkly; 1995 Oct 09; ():12-3. PubMed ID: 12290606.
    Abstract:
    Improved sexually transmitted disease (STD) treatment reduced HIV infection by about 40% in a rural population in Tanzania. The objectives of the trial were to establish a program for the improved diagnosis and treatment of STDs within the Tanzanian primary health care system in the general population, and to measure the impact of this intervention on the incidence of HIV infection and on the prevalence and incidence of STDs. The study was conducted in the rural Mwanza region of Tanzania. HIV incidence was compared in 6 intervention communities and 6 pair-matched comparison communities. A random cohort of about 1000 adults 15-54 years old from each community was surveyed at baseline and at follow-up 2 years later. Intervention consisted of establishment of an STD reference clinic, staff training, regular supply of drugs, regular supervisory visits to health facilities, and health education about STDs. A total of 12,537 persons were recruited for the study. Baseline HIV prevalences were 3.8% and 4.4% in the intervention and comparison communities, respectively. At follow-up 8845 (71%) of the cohort were seen. Of those initially seronegative, the proportions seroconverting over 2 years were 48 of 4149 (1.2%) in the intervention communities and 82 of 4400 (1.9%) in the comparison communities. HIV incidence was consistently lower in the intervention communities in all 6 matched pairs. Allowing for the community-randomized design and the effects of confounding factors, the estimated risk rate was 0.58. No change in reported sexual behavior was observed in either group. The improved STD treatment reduced HIV incidence by about 40% in this rural population. The demonstration that HIV incidence can be almost halved by a modest intervention in one of the world's most disadvantaged countries should provide a message of hope.
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