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A case controlled study about HIV seroprevalence among women with post-partum endometritis-myometritis (PPEM) matched with two controls. Each was performed in a non-governmental organization hospital in Kampala, Uganda. All participants were offered HIV pre- and post-test counselling. Personal and clinical information was obtained and HIV-1 ELISA tests performed on blood samples and discordant results resolved by Western blot test. HIV-1 seroprevalence was significantly higher among women with PPEM than controls, 26 (42.3%) and 26 (21.3%) respectively (P = 0.002). Women with PPEM were two-and-a-half times more likely to be HIV-positive than controls, odds ratio 2.74 (95% CI 1.34-5.65). Single or cohabiting women and low salaried women were also significantly more among PPEM cases than controls. In conclusion, PPEM cases had significantly higher seroprevalence of HIV-1 infection than controls and this needs further elucidation for purposes of management strategies.

The objective was to explore if HIV-1 infection is a risk factor for post-abortion endometritis-myometritis (PAEM) in an urban hospital in Kampala, Uganda. HIV-1 seroprevalence in women with and without post-abortion infection was established using two standard enzyme-linked immunosorbent assays. Fifty-two women with PAEM and 106 without PAEM infection were recruited. The HIV-1 seroprevalence was 17 (32.7%) among women with PAEM and 38 (36.5%) among women without post-abortion infection. HIV infection was not found to correlate with the risk for PAEM. HIV-1 seroprevalence in both groups was double that among antenatal clients in the same hospital, 14.6% in 1997. Life-threatening infections such as septicaemia, peritonitis and pelvic abscesses were observed among 12 cases (23%). HIV-1 infection was not shown to be a risk factor for PAEM, but women with abortions with and without PAEM have a higher prevalence of HIV-1 than antenatal clients.

Rapid, on-site HIV testing with same-day results may improve services and increase the number of clients who learn their serostatus in developing countries. To validate test performance under field conditions and assess the change in the proportion of clients who learn their serostatus, we conducted a field trial using the Capillus HIV-1/HIV-2 assay (Cambridge Diagnostics) at the AIDS Information Centre counselling and testing sites in Uganda. Compared to the standard 2-EIA testing algorithm, the sensitivity of Capillus was 99.6% (95% CI; 98.5%, 99.9%), the specificity was 98.8% (95% CI; 98.1%, 99.3%), the positive predictive value was 96.5% (95% CI; 94.5%, 97.8%), and the negative predictive value was 99.9% (95% CI; 99.5%, 100%). It took less than 5 min to perform a single test, and results were returned to clients in less than an hour, during which time clients were counselled. This resulted in a 27% increase in the proportion of clients who learned their serostatus and received counselling. We conclude that simple, rapid HIV tests can be performed accurately on-site within the time frame of a clinic visit, increasing the number of clients who learn their serostatus and receive post-test counselling.