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  • Title: HIV spread in four sub-Saharan African cities.
    Journal: AIDS Anal Afr; 2000 Jan; 10(4):9-10. PubMed ID: 12349440.
    Abstract:
    This article presents the results of a multi-site study that aimed to clarify the reasons for the variations in the spread of HIV infection in sub-Saharan Africa. Behavioral and serological surveys of 1000 males and 1000 females were conducted in two high- and two low-prevalence locations. Results revealed that HIV infection and sexually transmitted diseases (STDs) were more prevalent among women than men, and were more pronounced among individuals aged 15-19 years in all sites. A high rate of sex partner exchange was observed in low-prevalence areas. High-prevalence areas had more girls who had their sexual debut before the age of 15, greater proportion of married people, and lower age at first marriage than low-prevalence areas. Among married teenage women in high-prevalence locations, higher age of husband was associated with greater risk of HIV infection. Meanwhile, condom use was low among men in all areas. Genital herpes (HSV-2) was more common in high-prevalence settings, and in all 4 locations HSV-2 was associated with increased risk of HIV infection. Male circumcision was almost universal in the low-prevalence areas, whereas only 10-30% of men in high-prevalence sites were circumcised. In a multivariate analysis, being circumcised was significantly linked to a lower risk of the infection. Overall, early sexual debut of females and age at first marriage of men, as well as STDs, were significantly associated to increasing risk of HIV infection. Efforts to reduce HIV infection should consider these factors.
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