Human immunodeficiency virus and malaria in a representative sample of childbearing women in Kigali, Rwanda

Article Abstract:

Infection with the human immunodeficiency virus (HIV), which causes AIDS, is prevalent in east and central Africa, particularly in the cities. After infection with HIV, the body produces antibodies, or immune proteins, directed against the virus. The detection of HIV-specific antibodies in the blood indicates HIV infection, and provides a method of determining the incidence (number of new cases) of HIV disease. A previous study reported that the prevalence (number of cases) of HIV antibodies was one percent in rural areas of Rwanda, 18 percent among city residents, and 30 percent among city residents aged 26 to 40 years. Malaria is a disease caused by the infection of red blood cells with the parasitic sporozoan Plasmodium. Although HIV disease and malaria are prevalent in the same areas of Africa, the relation between these two infections is not clear. The relations among HIV antibodies, malaria, history of blood transfusion, and demographic factors were assessed in 3,702 women who attended prenatal and pediatric clinics in Kigali, Rwanda between 1986 and 1987. HIV antibodies were detected in 29 percent of subjects and malaria parasites in 9 percent. City residents tended to have a greater prevalence of HIV antibodies, but a lower incidence of malarial parasites, compared with women who lived on the outskirts of the city. There was no relation between the prevalence of HIV disease and that of malaria. HIV disease was detected in 45 percent of women who received a blood transfusion between 1980 and 1985, a period before the start of screening of donated blood. While 94 percent of the total group had never been transfused, 28 percent of these women were found to have HIV antibodies. The incidence of HIV disease was 44 percent among single mothers; 34 percent among women in common law relationships; and 20 percent among married women. The high prevalence of HIV infection in the female population of Kigali, Rwanda underlines the need for preventive programs that focus on reducing the spread of this sexually transmitted disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Malaria, HIV antibodies

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Human immunodeficiency virus infection in urban Rwanda: demographic and behavioral correlates in a representative sample of childbearing women

Article Abstract:

AIDS is the most severe manifestation of the spectrum of diseases caused by human immunodeficiency virus (HIV) infection. East and central Africa account for 85 percent of the world's reported cases of AIDS. In these areas, HIV is transmitted by heterosexual contact, contaminated blood transfusions and from mother to baby. A study was undertaken in Rwanda, a French-speaking country in central Africa, to determine the behavioral and demographic risk factors for HIV infection in this region. A sample of 1,458 woman attending pediatric and prenatal clinics in Kigali, Rwanda underwent blood tests to identify those women who were infected with the HIV virus. HIV infection was determined by enzyme immunoassay, a test that reveals the presence of antibodies to HIV; antibodies are protein substances that develop in response to the presence of an antigen, in this case the HIV virus. The HIV seroprevalence (incidence of positive HIV antibody tests) was 32 percent. The rate of infection was highest in single women, and those in steady relationships since 1981. Lower infection rates (in the order of 20 percent) were found in legally married women and those with only one life-time sexual partner. The strongest risk factor for HIV seropositivity was a history of venereal disease within the last five years; such a history was reported in 30 percent of the infected women. Having a partner who drank alcohol or had a higher income was also a significant risk factor. These findings indicate that, in Rwanda, AIDS has spread beyond the recognized high-risk groups (such as prostitutes) to groups of women without known risk factors. A steady male partner is the source of HIV infection for most women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, International aspects, Women, Risk factors, HIV (Viruses), HIV, Disease transmission, Women's health, AIDS (Disease), HIV seroprevalence

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Confidential HIV testing and condom promotion in Africa: impact on HIV and gonorrhea rates

Article Abstract:

Confidential HIV testing and counseling may increase the use of condoms and spermicide and decrease the incidence of HIV infection and gonorrhea among heterosexual African women. Among 1,458 urban Rwandan women of childbearing age who underwent confidential HIV testing and counseling, 988 (68%) were HIV-negative and 460 (32%) were HIV-positive. Seven percent of the women had used condoms before being tested for the HIV virus, compared with 22% who reported using condoms on a regular basis one year after undergoing testing. Thirty-six percent of the women who were HIV-positive used condoms regularly after undergoing testing, compared with 16% of the women who were HIV-negative. Of the 922 HIV-negative women who were retested two years after their initial test, the rate of conversion to HIV-positive decreased significantly if their partners also received educational information and were tested. The number of HIV-positive women who developed gonorrhea was significantly lower one year after undergoing HIV testing than before, especially among those who used condoms and spermicide.

Usage, Prevention, Condoms, Gonorrhea, HIV testing, HIV tests

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