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Lancet. 1986 Nov 15;2(8516):1113-5.

Evidence for heterosexual transmission and clinical manifestations of human immunodeficiency virus infection and related conditions in Lusaka, Zambia.

Abstract

In a hospital-based survey in Lusaka, Zambia, 189 (17.5%) of 1078 subjects had antibodies against the human immunodeficiency virus (HIV). The prevalence of antibodies was low in subjects aged less than 20 or greater than 60 years; in men the peak prevalence (32.9%) occurred in those aged 30-35 years, and in women (24.4%) it occurred in the 20-25 year age-group. There was no significant difference in prevalence by sex after adjusting for age. High educational level was independently associated with HIV seropositivity; the antibody against HIV was found in 18.4% of blood donors and in 19.0% of hospital workers. Among patients the antibody prevalence ranged from 8.7% in antenatal women and 9.3% in orthopaedic patients to 29.2% in those attending sexually transmitted disease (STD) clinics (the prevalence being 37.3% in previous attenders and 22.8% in first-time attenders). Seropositivity rates were higher in patients with an infectious problem (23.4%) than in those without (11.4%, p = 0.0002). Herpes zoster, oral thrush, diarrhoea, tuberculosis, and weight loss were independently correlated with seropositivity. The data strongly suggest that HIV infection is prevalent in Africa and is transmitted heterosexually. The restricted distribution of seropositivity to the sexually active age-groups indicates that the epidemic, at least in this part of Africa, is newly introduced; this has substantial implications for prevention.

PIP:

In a hospital-based survey conducted in Lusaka, Zambia, 189 (17.5%) of 1078 patients, blood donors, and health workers had antibodies against human immunodeficiency virus (HIV). The prevalence of antibodies (seropositivity) was low in study subjects under age 20 and over age 60. Seropositivity was highest among men age 30-35 (32.9%) and among women age 20-25 (24.4%). There was no significant difference in prevalence by sex, after adjusting for age. Increasing years of education was highly correlated with seropositivity, even after adjustment for age, sex, and marital status. This association presumably reflects the greater opportunities for travel and social interaction--and thus HIV exposure--among the better educated. The antibody against HIV was detected in 18.4% of blood donors and 19.0% of hospital workers. Among clinic patients, antibody prevalence was lowest among pregnant women (8.7%) and orthopedic patients (9.3%) and highest among those attending the dermatology (26.8%) and sexually transmitted disease (29.2%) clinics. Moreover, patients who had attended the sexually transmitted disease clinic more than once were more likely to be seropositive (37.3%) than first-time attendees (22.8%). Finally, patients with infectious conditions had significantly higher seropositivity rates (23.4%) than those with noninfectious problems (11.4%). Herpes zoster, oral thrush, diarrhea, tuberculosis, and weight loss were independently associated with seropositivity. These findings strongly suggest that HIV infection is prevalent in Africa and is transmitted heterosexually. The concentration of seropositivity in the sexually active age groups indicates that the epidemic is newly introduced, at least in this part of Africa.

PMID:
2877269
[PubMed - indexed for MEDLINE]
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