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  • Title: HIV infection among patients with sexually transmitted diseases in rural South Africa.
    Author: Wilkinson D, Wilkinson N.
    Journal: Int J STD AIDS; 1998 Dec; 9(12):736-9. PubMed ID: 9874120.
    Abstract:
    A cross-sectional study of 360 patients presenting with sexually transmitted diseases (STDs) to a primary care clinic in KwaZulu/Natal, South Africa was done. Prevalence of HIV infection was 42.5%. HIV-infected patients were of similar age to uninfected patients (mean age 25.1 vs 26.1 years), but were less likely to be married (9.2% vs 18.8%; P=0.02). HIV prevalence was highest among young women (47.9% among women aged 15-34 years compared with 33.1% among men of the same age; P=0.03). History of a previous STD in the preceding 3 months was high (40.1% in HIV-infected patients). Similar proportions of the HIV-infected and HIV-uninfected had sought care for the previous illness at private practitioners (16.9%), and primary care clinics (50.0%), and traditional healers (14.6%) or had treated themselves (18.5%). Patients with an STD are at very high risk of HIV infection in this setting. Repeat STDs are frequent and opportunities exist to improve treatment seeking behaviour, to reduce the risk of recurrent STDs, and hence to reduce the incidence of HIV infection. Since STDs facilitate the transmission of HIV, the high prevalence of STDs in sub-Saharan Africa has probably contributed substantially to the HIV epidemic in the region. More than 90% of HIV infections may be attributed to STDs in the early phase of an HIV epidemic. South Africa is currently in the throes of an explosive HIV epidemic. For example, the prevalence of HIV infection among women attending public sector antenatal clinics in rural Hlabisa district increased from 4.2% in 1992 to 25.9% in 1997. Findings are presented from a cross-sectional study of 360 patients presenting with STDs to the outpatient department of Hlabisa hospital in KwaZulu/Natal, South Africa. 42.5% of the subjects were infected with HIV. HIV-infected patients and uninfected patients were of mean ages 25.1 and 26.1 years, respectively, but only 9.2% of the former subjects were married, compared to 18.8% of those who were uninfected. 47.9% of women and 33.1% of men aged 15-34 years were infected with HIV. 40.1% of HIV-infected patients had a history of a previous STD infection in the preceding 3 months. Similar proportions of the HIV-infected and HIV-uninfected patients had sought care for their previous illness at private practitioners (16.9%), primary health care clinics (50.0%), and traditional healers (14.6%), or had treated themselves (18.5%). STD patients are at very high risk of HIV infection in this setting.
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