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Skip Navigation LinksHome > February 28, 2006 - Volume 20 - Issue 4 > Association between genital schistosomiasis and HIV in rural...
AIDS:
doi: 10.1097/01.aids.0000210614.45212.0a
Epidemiology and Social

Association between genital schistosomiasis and HIV in rural Zimbabwean women

Kjetland, Eyrun Fa; Ndhlovu, Patricia Db; Gomo, Exeneviab,c; Mduluza, Takafirab; Midzi, Nicholasc; Gwanzura, Lovemoreb; Mason, Peter Rb,d; Sandvik, Leive; Friis, Henrikf; Gundersen, Svein Gunnarg

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Abstract

Objective: To determine the association between female genital Schistosoma haematobium infection and HIV.

Design and methods: A cross-sectional study with a 1-year follow-up. Gynecological and laboratory investigations were performed for S. haematobium and HIV. Sexually transmitted infections, demographic and urogenital history were analysed as confounders. The participants were 527 sexually active, non-pregnant, non-menopausal women between the ages of 20 and 49 years. The setting was a rural Zimbabwean community where S. haematobium related lesions were found in 46% of the women, HIV in 29% and herpes simplex type- 2 (HSV-2) in 65%.

Results: In permanent residents (>3 years residency), HIV was found in 41% (29/70) of women with laboratory proven genital schistosomiasis as opposed to 26% HIV positive (96/375) in the schistosomal ova negative group [odds ratio (OR), 2.1; 95% confidence interval (CI), 1.2–3.5; P = 0.008. In multivariate analysis S. haematobium infection of the genital mucosa was significantly associated with HIV seropositivity (adjusted OR, 2.9; 95% CI, 1.11–7.5; P = 0.030). All seven women who became HIV positive during the study period (seroincidence 3.1%) had signs of S. haematobium at baseline. In accordance with other studies HIV was significantly associated with HSV-2 (OR, 3.0; 95% CI, 1.7–5.3; P < 0.001), syphilis and human papillomavirus. The highest HIV prevalence (45%) was found in the 25–29 years age group.

Conclusion: Women with genital schistosomiasis had an almost three-fold risk of having HIV in this rural Zimbabwean community. Prospective studies are needed to confirm the association.

© 2006 Lippincott Williams & Wilkins, Inc.

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