Title: Rapid increase of both HIV-1 infection and syphilis among pregnant women in Nairobi, Kenya.

POPLINE Document Number: 076402

Author(s):

Temmerman M
Ali FM
Ndinya-Achola J
Moses S
Plummer FA
Piot P

Source citation:

AIDS, 1992 Oct;6(10):1181-5.

Abstract:

Between January 1989 and December 1991, health workers took blood samples from 4883 pregnant women attending the Nairobi City Commission's Langata Clinic in Nairobi, Kenya to determine demographic factors and indicators of sexual behavior to explain the increase in HIV-1 infection and syphilis among these women of low socioeconomic status. HIV-1 seroprevalence stood at 8.8%. Syphilis seroreactivity was 3.6%. HIV-1 seropositive mothers were 2.5 times more likely to also test positive for syphilis than were HIV-1 seronegative mothers (7.7% vs. 3.2%; p<.001). There was no significant association between HIV-1 seropositivity and gonococcal infection rate (7.3% vs. 8.9%), however. Women who tested HIV-1 positive tended to be from western Kenya (60.1% vs. 39.1%; p<.0001). Between 1989 and 1991, annual HIV-1 seroprevalence rates increased from 6.5% to 13% (p<.001) as did annual syphilis seroreactivity rates (2.9-5.3%; p=.02). The HIV-1 seroprevalence rates remained high, but did not rise significantly among syphilis seroreactive women between 1989 and 1991 (17.9-20.7%). They did rise among syphilis seronegative women (6.9-12.5%; p<.0001), however. The HIV-1 infection rate increase was greater among <25-year old women (5.6-13.2%; p<.001) than it was among >25-year old women (6.8-12.7%; p=.09). Indeed the annual incidence rate for <25-year old women was 3-4%. Between 1989-1991, there was a decrease in the percentage of both HIV-1 seropositive and seronegative women who had had >1 sex partner during the last 2 years (39.1% vs. 20%; p=.0001). Demographic factors remained the same throughout the study period. These results verified the link between HIV-1 infection and syphilis and their rapid rise among women in low risk groups. Thus there was a pressing need to improve HIV-1 and sexually transmitted disease prevention programs.

Keywords:

Kenya
Methodological Studies
Prospective Studies
HIV Testing
HIV Infections
Syphilis
Pregnant Women
Urban Population
Screening
Low Income Population
Gonorrhea
Changes
Women
Developing Countries
Africa, Eastern
Africa, Sub Saharan
Africa
Studies
Research Methodology
Laboratory Examinations and Diagnoses
Examinations and Diagnoses
Viral Diseases
Diseases
Sexually Transmitted Diseases
Reproductive Tract Infections
Infections
Population Characteristics
Demographic Factors
Population
Social Class
Socioeconomic Status
Socioeconomic Factors
Economic Factors
Social Change