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Though the World Health Organization (WHO) has acted to reduce the price of anti-HIV assays for developing countries, the cost of the large-scale testing to be done may still be prohibitive to the health budget of these countries. GACPAT, a modified commercial particle assay, is ten times cheaper than the WHO price of ELISAs. In this study GACPAT was introduced in three district hospital laboratories (DHL) in Tanzania, and the results compared with those on the same sera in a reference laboratory (RL). Sensitivity and specificity were 92.6% and 98.7%, respectively at DHL. It is concluded that GACPAT is a valid, feasible and cheap alternative for ELISA anti-HIV-testing also at district hospital laboratory level.

A cohort study has been started of urban factory workers and their spouses in Tanzania, in order to 1) identify risk factors for HIV-1 seroconversion, and 2) document changes over time in risk behaviour, in particular condom use and partner change, and determine whether these are associated with a reduced incidence of HIV-1 and other sexually transmitted diseases. We report findings at intake from October 1991 to March 1992. Study participants were interviewed, examined, and screened for HIV-1 and syphilis. HIV-1 prevalence was 91/926 (10%) in males and 36/217 (17%) in females. Statistically significant risk factors for HIV-1 infection in males were age group, region of birth, not being married for more than 5 years, being uncircumcised, having had a genital ulcer in the past four months, and having received injections from medical staff in the past four months. HIV-1 incidence in this group is expected to be between 1% and 2% per year. It is concluded that a longitudinal study is needed to assess the importance of partner change. This cohort appears to be suitable for such a study as HIV-1 incidence is expected to be fairly high, HIV-1 prevalence and risk factors are comparable to those of the general population and cooperation of the factory workers is good.