Search

In January 1987, HIV antibodies were detected by means of an immunoenzymatic assay, indirect immunofluorescence and Western blot in 52 out of 302 male urban-based professionals and in 28 out of 150 health workers in Kigali, Rwanda. Univariate analysis showed an association between HIV seropositivity and a history of sexually transmitted diseases (STD), blood transfusion, medical injections for treatment of STD, and medical injections for treatment of febrile illnesses. However, injection related to treatment of other conditions were not associated with HIV seropositivity. Among health workers, no association between HIV seropositivity and professional or accidental exposure to HIV-infected patients or to their body fluids was identified. Discriminant analysis showed that HIV seropositivity was associated only with a history of STD and with a history of blood transfusion. In central Africa, a history of STD and a history of blood transfusion should be considered as risk factors for HIV seropositivity. Medical or accidental injections do not seem to play a major role in the transmission of HIV among adults in central Africa.

Detection of HIV antibodies by means of an immunoenzymatic assay, an indirect immunofluorescence technique and Western blot was attempted on 375 serum samples collected in the Murunda area, a remote rural area situated in Rwanda, central Africa. Two out of 147 (1.4%) adults from a strict rural area, five out of 59 (8.5%) adults from an adjacent market place, and 49 out of 169 (30%) STD clinic attenders from the same area were HIV seropositive. In the first two groups, HIV seropositivity was associated with a history of sexually transmitted disease (STD) in the previous 2 years (P less than 0.001) and with a history of travel to a Rwandese urban centre in the previous 5 years (P less than 0.05). This study suggests that HIV seroprevalence is low in rural central Africa compared with urban centres. Risk factors for HIV seropositivity are similar in rural and urban-based adults in Rwanda, i.e. heterosexual promiscuity and STDs. Many HIV seropositive rural subjects from this study are likely to have acquired HIV infection through sexual contacts in Rwandese cities.

From February to June 1986, 150 heterosexual couples with at least one HIV-seropositive member were recruited in the 'Centre Hospitalier de Kigali', Kigali, Rwanda. Of the 138 HIV-seropositive couples in whom both members were tested, 124 (90%) were sexual unions between two antibody-positive partners, illustrating the high efficiency of the heterosexual transmission of HIV. A comparison of these 124 couples with 150 HIV-seronegative couples showed that, in the husbands, seropositivity is significantly associated with sexual contacts with prostitutes and history of sexually transmitted disease (STD) within the past 2 years. Seropositive wives were less likely to be in their first marriage and reported more episodes of STD than seronegative ones. Seropositive couples were similar to seronegatives in their history of blood transfusion, male circumcision and overall use of contraception but not in their use of oral contraceptive pills, which was more frequent; they were more often in polygamous unions. Discriminant analysis showed that STD, sexual contacts with prostitutes and the number of previous unions are the most powerful independent variables associated with the seropositivity of the couples. Most of the risk factors for the couples were the risk factors for the husband, suggesting that in most cases the husband acquired the HIV infection and passed it to his wife.