23 results on '"Kapiga, Saidi"'
Search Results
2. A randomized trial of multivitamin supplements and HIV disease progression and mortality
- Author
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Fawzi, Wafaie W., Villamor, Eduardo, Mwakagile, Davis, Mugusi, Ferdinand, Hertzmark, Ellen, Essex, Max, Hunter, David J., Msanga, Gernard I., Speigelman, Donna, Wei, Ruilan, and Kapiga, Saidi
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Multivitamins -- Health aspects ,Vitamin A -- Research ,Vitamin A -- Health aspects ,HIV patients -- Drug therapy ,Pregnant women -- Surveys - Abstract
A study was conducted on 1078 pregnant HIV infected women in Tanzania to examine the effects of daily supplements of vitamin A and multivitamins on the progression of HIV disease, using survival models. The results show daily supplements of multivitamins delays the progression of HIV in the foetus.
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- 2004
3. Community-based therapy for multidrug-resistant tuberculosis in Lima, Peru
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Mitnick, Carole, Bayona, Jaime, Palacios, Eda, Shin, Sonya, Furin, Jennifer, Alcantara, Felix, Sanchez, Epifanio, Sarria, Madeleny, Becerra, Mercedes, Fawzi, Mary C. Smith, Kapiga, Saidi, Neuberg, Donna, Maguire, James H., Kim, Jim Yong, and Farmer, Paul
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Drug resistance in microorganisms ,Tuberculosis -- Drug therapy ,Ambulatory medical care -- Evaluation - Abstract
It may be possible to treat patients with multi-drug resistant tuberculosis in a community setting in poor countries, according to a study from Lima, Peru. Of 66 patients who were treated in a medical clinic, five died during the six-month treatment, but most of the rest were cured. Pyrazinamide and ethambutol were especially effective provided the bacterium was not resistant.
- Published
- 2003
4. Transmission of HIV-1 through breastfeeding among women in Dar es Salaam, Tanzania
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Fawzi, Wafaie, Msamanga, Gernard, Spiegelman, Donna, Renjifo, Boris, Bang, Heejung, Kapiga, Saidi, Coley, Jenny, Hertzmark, Ellen, Essex, Max, and Hunter, David
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Epidemiology -- Statistics ,Epidemiology -- Research ,HIV patients -- Demographic aspects ,HIV patients -- Case studies ,HIV patients -- Health aspects ,HIV patients -- Care and treatment ,HIV infection -- Demographic aspects ,HIV infection -- Prevention ,HIV infection -- Research ,HIV infection -- Health aspects ,Breast feeding -- Health aspects ,Antiviral agents -- Physiological aspects ,AIDS (Disease) -- Research ,Health - Abstract
Research has been conducted on HIV-1 transmission via breastfeeding by HIV-infected women in Dar es Salaam, Tanzania. Results demonstrate that the rate of HIV-1 breastfeeding transmission is high and that antiviral drugs given to these mothers may reduce HIV-1 transmission risk through breastfeeding.
- Published
- 2002
5. Correlates of plasma HIV-1 RNA viral load among HIV-1 seropositive women in Dar es Salaam, Tanzania
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Kapiga, Saidi H., Bang, Heejung, Spiegelman, Donna, Msamanga, Gernard I., Coley, Jenny, Hunter, David J., and Fawzi, Wafaie W.
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Epidemiology -- Statistics ,Epidemiology -- Research ,HIV patients -- Demographic aspects ,HIV patients -- Health aspects ,HIV patients -- Care and treatment ,HIV infection -- Demographic aspects ,HIV infection -- Prevention ,HIV infection -- Research ,HIV infection -- Health aspects ,RNA -- Genetic aspects ,Serodiagnosis -- Methods ,Pregnant women -- Diseases ,Pregnant women -- Health aspects ,Pregnant women -- Demographic aspects ,Health - Abstract
Research has been conducted on the predictors of plasma HIV-1 RNA viral load among HIV-1 seropositive pregnant women. Results demonstrate that prevention of malaria among the people living with HIV-1 should be given high priority.
- Published
- 2002
6. HIV-1 epidemic among female bar and hotel workers in northern Tanzania: risk factors and opportunities for prevention
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Kapiga, Saidi H., Sam, Noel E., Shao, John F., Renjifo, Boris, Masenga, Elisante J., Kiwelu, Ireen E., Manongi, Rachel, Fawzi, Wafaie, and Essex, Max
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Prostitutes -- Diseases ,HIV infection -- Risk factors ,Health - Abstract
Women who serve as prostitutes in bars and hotels in northern Tanzania are at high risk of HIV infection. In a study of 312 female bar and hotel workers who supplemented their income by working as prostitutes, 26% tested positive for HIV. Risk factors included increased age, number of sexual partners, and the presence of another sexually transmitted disease.
- Published
- 2002
7. Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania
- Author
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Fawzi, Wafaie W., Msamanga, Gernard, Hunter, David, Urassa, Ernest, Renjifo, Boris, Mwakagile, Davis, Hertzmark, Ellen, Coley, Jenny, Garland, Miriam, Kapiga, Saidi, Antelman, Gretchen, Essex, Max, and Spiegelman, Donna
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HIV infection in children -- Prevention ,Vitamin therapy -- Health aspects ,Health - Abstract
Vitamin supplements do not prevent an HIV-infected pregnant woman from transmitting the virus to her baby. This was the conclusion of a study of 1,083 pregnant women who were randomly assigned to receive a multivitamin, vitamin A alone, or no vitamins.
- Published
- 2000
8. Alcohol use before sex and HIV risk: situational characteristics of protected and unprotected encounters among high-risk African women
- Author
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Fisher, Joseph C., Cook, Peter A., and Kapiga, Saidi H.
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Condoms -- Usage ,Condoms -- Health aspects ,HIV infection -- Risk factors ,HIV infection -- Prevention ,Safe sex -- Health aspects ,Drinking of alcoholic beverages -- Complications and side effects ,Health - Abstract
Objectives: To compare the situational characteristics of protected and unprotected sexual encounters that involved alcohol use 2 hours prior with ones that did not. Methods: Data were collected between December 2002 and December 2005 as part of enrollment in a prospective cohort study designed to identify HIV seroconversion risk factors among women bar and hotel workers in Northern Tanzania. A total of 608 (37.3%) of the women who were inconsistent condom users were asked a set-matched questions concerning situational characteristics surrounding their last protected and unprotected sexual encounter including whether they had been drinking within 2 hours of sex. The associations between drinking 2 hours before sex (yes/no), condom use (protected/unprotected), and their interaction with the situational descriptors were examined with a 2 x 2 model for paired categorical data after controlling for time since the last type of encounter. Results: Condom failure was 5 times more likely if someone (woman, man, or both partners) had been drinking in advance of the encounter (OR, 5.19; 95% CI, 2.05-15.46) and was especially likely to occur if only the woman had been drinking before sex (OR, 14.05; 95% CI, 4.03-50.41). Alcohol use before sex was associated with sexual contacts where the woman was having sex with her partner for the first time, their relationship was casual or transitory or sex was transactional, the location was unfamiliar and less under her control, and the partner had been drinking or using drugs before having sex. Condom use was more frequent in precisely the same types of encounters. Interestingly, there were no significant interactions between alcohol use before sex and condom use, suggesting that drinking before sex and use of condom are distinct and not contingent risk factors. Conclusions: Alcohol use before sex is associated with an increased likelihood of condom failures and with high-risk sexual encounters, ones that have consistent situational characteristics regardless of whether condoms are used or not. DOI:10.1097/0LQ.0b013e318dbadfad
- Published
- 2010
9. Risk factors for incidence of sexually transmitted infections among women in South Africa, Tanzania, and Zambia: results from HPTN 055 study
- Author
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Kapiga, Saidi, Kelly, Cliff, Weiss, Stephen, Daley, Tara, Peterson, Leigh, Leburg, Corey, and Ramjee, Gita
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Sexually transmitted diseases -- Risk factors ,Sexually transmitted diseases -- Demographic aspects ,Epidemiology -- Research ,Risk factors (Health) -- Demographic aspects ,Sex -- Health aspects ,Health - Abstract
Objective: To determine risk factors for sexually transmitted infections (STIs) among women in Durban and Hlabisa (South Africa), Moshi (Tanzania), and Lusaka (Zambia). Study Design: Between 2003 and 2004, 958 women at risk of STIs were enrolled in a 1-year prospective study. They were interviewed at each monthly visit, and samples for STI testing were collected during quarterly and other visits when clinically indicated. Results: The incidence of infections as measured in person-years at risk (PYAR) was as follows: overall trichomoniasis, 31.9/100 PYAR; chlamydial infection in South Africa, 19.5/100 PYAR; chlamydial infection in Tanzania and Zambia, 4.9/100 PYAR; gonorrhea in South Africa, 16.5/100 PYAR; gonorrhea in Tanzania and Zambia, 5.3/100 PYAR; overall syphilis, 7.5/100 PYAR; and overall HIV, 3.8/100 PYAR. The incidence of most STIs was highest among the South African sites, where chlamydial infection and gonorrhea were detected by using a more sensitive assay. Independent risk factors included age, hormonal contraceptive methods, and measures of sexual behavior, including number of sex partners and occurrence of anal sex in the past 3 months. Women with incident HIV infection were at increased risk of chlamydial infection [odds ratio (OR) = 5.5, 95% confidence interval (CI): 2.0-15.2]and gonorrhea (OR = 5.7, 95% CI: 1.9-17.0) in South African sites. Despite ongoing counseling during the study, high-risk sexual behaviors were common, and consistent condom use remained low. Conclusions: The incidence of STIs, including HIV, was high among women in this study. These findings highlight the urgent need for effective HIV/STI prevention programs in this population.
- Published
- 2009
10. Patterns of alcohol use, problem drinking, and HIV infection among high-risk African women
- Author
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Fisher, Joseph C., Cook, Peter A., Sam, Noel E., and Kapiga, Saidi H.
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Women -- Health aspects ,Women -- Alcohol use ,HIV infection -- Diagnosis ,HIV infection -- Research ,HIV infection -- Risk factors ,HIV infection in women -- Health aspects ,HIV infection in women -- Alcohol use ,Health - Abstract
Objectives: To examine the relationship between patterns of alcohol use and HIV infection and to assess the association between problem drinking and the prevalence of risk factors for HIV among a sample of high-risk African women. Methods: Baseline data were collected between 2002 and 2003 during enrollment of 1050 women in a prospective cohort study designed to assess risk factors for HIV. Information about demographic and employment characteristics, sexual behaviors, and drinking patterns were obtained by interviews. The CAGE questionnaire was used to assess problem drinking. The association between measures of alcohol use and HIV/STDs and sexual behaviors were summarized using odds ratios, adjusted odds ratios (AOR), and 95% confidence intervals (CI). Results: HIV prevalence was 19.0% (95% CI, 16.6%-21.4%). Overall 73.9% of the women drank alcohol whereas 34.6% were classified as problem drinkers. After adjusting for demographic and employment variables, drinkers were at increased risk to be HIV+ when compared with nondrinkers (AOR, 2.10; 95% CI, 1.29-3.42). Greater involvement with alcohol, as indicated by recency, frequency and quantity consumed, was associated with increased risk. Problem drinkers were at greater risk to be HIV+ than nonproblem drinkers (AOR, 1.79; 95% CI, 1.06-3.04 vs. AOR, 2.43; 95% CI, 1.45-4.06). Problem drinkers were also more likely to have engaged in several types of high-risk sexual behaviors and to have other STD infections including HSV-2. Conclusion: Programs aiming at limiting alcohol use or promoting abstinence from alcohol might help to reduce high-risk behaviors and lower the burden of HIV/STDs ill this population.
- Published
- 2008
11. Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania
- Author
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Fawzi, Wafaie W., Msamanga, Gernard I., Spiegelman, Donna, Urassa, Ernest J.N., McGrath, Nuala, Mwakagile, Davis, Antelman, Gretchen, Mbise, Roger, Herrera, Guillermo, Kapiga, Saidi, Willett, Walter, and Hunter, David J.
- Subjects
Vitamin A -- Health aspects ,Vitamin therapy -- Evaluation ,HIV infection in pregnancy -- Drug therapy ,Birth weight, Low -- Health aspects ,T cells -- Health aspects - Published
- 1998
12. The association between HIV infection and alcohol use: a systematic review and meta-analysis of African studies
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Fisher, Joseph C., Bang, Heejung, and Kapiga, Saidi H.
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Drinking of alcoholic beverages -- Health aspects ,HIV infection -- Analysis ,HIV infection -- Risk factors ,HIV infection -- Health aspects ,Health - Abstract
To summarize the association between alcohol use and human immunodeficiency virus (HIV) infection based on studies conducted in Africa, EMBASE and PubMed were searched for African studies that related alcohol use to HIV infection. Meta-analyses were conducted to obtain pooled univariate and multivariate relative risk estimates. Subgroup analyses were performed for studies having different sample types: males or females and population-based or high-risk, and ones that differentiated between problem and asymptomatic drinkers. Alcohol drinkers were more apt to be HIV+ than nondrinkers. The pooled unadjusted odds' ratio (OR) from 20 studies was 1.70 (95% confidence interval CI = 1.45-1.99). Results front I1 studies that adjusted for other risk factors produced a pooled risk estimate of 1.57 (95% CI = 1.42-1.72). Males and females had similar risk estimates, while studies involving high-risk samples tended to report larger pooled odds' ratios than studies of the general population. When compared with nondrinkers', the pooled estimates of HIV risk were 1.57 (95% CI = 1.33-1.86) for nonproblem drinkers' versus 2.04 (95% CI = 1.61-2.58)for problem drinkers, a statistically significant difference (z = 2.08, P
- Published
- 2007
13. The role of herpes simplex virus type 2 and other genital infections in the acquisition of HIV-1 among high-risk women in Northern Tanzania
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Kapiga, Saidi H., Sam, Noel E., Bang, Heejung, Ni, Quanhong, Ao, Trong T.H., Kiwelu, Ireen, Chiduo, Sarah, Ndibe, Uzodinma, Seage, George III, Coplan, Paul, Shao, John, Rosenberg, Zeda F., and Essex, Max
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Herpes simplex virus -- Research ,Genital diseases, Female -- Research ,HIV infection -- Risk factors ,Health - Published
- 2007
14. Predictors of Herpes Simplex Virus type 2 prevalence and incidence among bar and hotel workers in Moshi, Tanzania
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Tassiopoulos, Katherine K., Seage, George III, Sam, Noel, Kiwelu, Ireen, Shao, John, Ao, Trong T.H., Essex, Max, Coplan, Paul, Rosenberg, Zeda, Hughes, Michael, and Kapiga, Saidi
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Herpes simplex virus -- Diagnosis ,Herpes simplex virus -- Research ,Hotel workers -- Health aspects ,Hotel workers -- Research ,HIV (Viruses) -- Risk factors ,Health - Published
- 2007
15. Design of a community-based study of sexually transmitted infections/HIV and infertility in an urban area of Northern Tanzania
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Larsen, Ulla, Mlay, Joseph, Aboud, Said, Ballard, Ronald, Sam, Noel E., Shao, John F., and Kapiga, Saidi H.
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Disease transmission -- Methods ,Infertility -- Analysis ,Sexually transmitted diseases -- Analysis ,Health - Abstract
Objective: The objective of this study was to describe the design of a community-based study of sexually transmitted infections (STIs)/ HIV and infertility in northern Tanzania. Study Design: Households were selected using a 2-stage sampling design. Eligible women and their partners were interviewed before samples were collected for STIs/HIV detection. Posttest counseling and treatment for STIs and infertility were provided. Results: A total of 2019 women and 794 male partners were interviewed. Over 70% of interviewed women and men provided blood and urine samples. Individuals providing blood and urine samples had high-risk profiles for STIs/HIV when compared with others who did not provide these samples. Although the study results may be affected by selection bias, risk factors for STIs/HIV were similar to those in other studies supporting the generalizability of the findings. Conclusions: It is feasible to conduct a community-based survey, including collection of biomarkers and measurement of infertility, in this urban setting.
- Published
- 2007
16. A community-based study of risk factors for Trichomonas vaginalis infection among women and their male partners in Moshi Urban District, Northern Tanzania
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Klinger, Elissa V., Kapiga, Saidi H., Sam, Noel E., Aboud, Said, Chen, Cheng-Yen, Ballard, Ronald C., and Larsen, Ulla
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Trichomoniasis -- Risk factors ,Trichomoniasis -- Diagnosis ,Trichomoniasis -- Care and treatment ,Women -- Health aspects ,Health - Abstract
Objective: The objective of this study was to determine predictors of Trichomonas vaginalis among women and their partners in Moshi, Tanzania. Study Design: Women (N = 1440) and their partners (N = 588) were interviewed and specimens for detection of T. vaginalis and sexually transmitted infections (STIs) were collected. Results: Prevalence of T. vaginalis was 10.7% in women and 6.3% in men. Having a partner with T. vaginalis was the strongest risk factor in women (adjusted odds ratio [OR], 19.44; 95% confidence interval [CI], 7.84-48.25) and men (adjusted OR, 19.01; 95% CI, 6.8-52.40). Risk of T. vaginalis infection was increased in subjects with less education. Other risk factors in women were daily alcohol consumption, being separated, reporting infertility problems, having a partner who had children with other women, and other STIs; and in men, the risk factor was having no income. T. vaginalis was not associated with HIV-1 in women and men. Conclusions: Prevention of T. vaginalis and other STIs among couples is a major priority. Reduction of alcohol consumption in women is an important intervention.
- Published
- 2006
17. Human immunodeficiency virus type 1 among bar and hotel workers in Northern Tanzania: the role of alcohol, sexual behavior, and herpes simplex virus type 2
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Ao, Trong T.H., Sam, Noel E., Masenga, Elisante J., Seage, George R., III, and Kapiga, Saidi H.
- Subjects
HIV (Viruses) -- Risk factors ,Hotel workers -- Health aspects ,Health - Abstract
Goals: We assessed baseline prevalence of human immunodeficiency virus type 1 (HIV-1) and other STDs, as well as behavioral and biologic risk factors for HIV-1 in a population of female bar/hotel workers in Moshi, Tanzania. Study Design: Between 2002 and 2003, we enrolled 1042 female bar/hotel workers in an ongoing prospective cohort study. We analyzed data collected at baseline to assess the associations between alcohol, sexual behavior, STDs, and HIV-1 infection. Results: The prevalence of HIV-1 infection was 19.0% (95% confidence interval [CI] = 16.6%-21.4%). Consistent condom use was low (11.1%). HIV-1 was associated with genital ulcers on examination (adjusted odds ratio [AOR] = 2.08, 95% CI = 1.16-3.74), herpes simplex virus type 2 (HSV-2) (AOR = 3.80, 95% CI = 2.42-5.97), and problem drinking (AOR = 1.92, 95% CI = 1.06-3.47). Other independent predictors of HIV-1 were increasing age, number of sex partners, cohabitating, formerly married, location of employment, and having a husband with another wife. Conclusions: These findings suggest that programs designed to control HSV-2, reduce the number of sexual partners and alcohol use, and promote condom use could be effective in reducing transmission of HIV-1 in this population.
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- 2006
18. Herpes simplex virus type 2 infection among bar and hotel workers in Northern Tanzania: prevalence and risk factors
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Kapiga, Saidi H., Sam, Noel E., Shao, John F., Masenga, Elisante J., Renjifo, Boris, Kiwelu, Ireen E., Manongi, Rachel, Fawzi, Wafaie W., and Essex, Max
- Subjects
Bartenders -- Diseases ,Herpes simplex virus ,Herpesvirus diseases -- Causes of ,Herpes ,Hotel workers -- Diseases ,Health - Abstract
Background: Type-specific serological tests have allowed for a better understanding of the epidemiology of herpes simplex virus type 2 (HSV-2) infection in Africa. Goal: The goal was to determine risk factors for HSV-2 among bar and hotel workers in Moshi, Tanzania. Study Design: A cross-sectional study was conducted involving 515 workers in randomly selected bars and hotels in Moshi. Results: The seroprevalence of HSV-2 was 43.5%. Women were more likely to be HSV-2-seropositive than men (age-adjusted OR = 3.8; 95% CI = 2.5-5.8). In multivariate analyses, age was positively associated with HSV-2 in both women and men. HIV-1-seropositive women had a significantly increased risk of HSV-2 infection (adjusted OR = 2.8; 95% CI = 1.5-5.1). Other predictors of HSV-2 were religion and sexual behavior for women and level of education, frequency of alcohol use, and concurrent partners for men. Conclusion: The most common genital infection was that with HSV-2. Control of HSV-2 might be an important strategy for HIV-1 infection prevention in this population.
- Published
- 2003
19. Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis
- Author
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Morrison, Charles S., Chen, Pai-Lien, Kwok, Cynthia, Baeten, Jared M., Brown, Joelle, Crook, Angela M., Van Damme, Lut, Delany-Moretlwe, Sinead, Francis, Suzanna C., Friedland, Barbara A., Hayes, Richard J., Heffron, Renee, Kapiga, Saidi, Karim, Quarraisha Abdool, Karpoff, Stephanie, Kaul, Rupert, McClelland, R. Scott, McCormack, Sheena, McGrath, Nuala, Myer, Landon, Rees, Helen, van der Straten, Ariane, Watson-Jones, Deborah, van de Wijgert, Janneke H.H.M., Stalter, Randy, and Low, Nicola
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HIV infections -- Risk factors ,Meta-analysis -- Usage ,Contraceptive drugs -- Complications and side effects ,Biological sciences - Abstract
Background Observational studies of a putative association between hormonal contraception (HC) and HIV acquisition have produced conflicting results. We conducted an individual participant data (IPD) meta-analysis of studies from sub-Saharan Africa to compare the incidence of HIV infection in women using combined oral contraceptives (COCs) or the injectable progestins depot-medroxyprogesterone acetate (DMPA) or norethisterone enanthate (NETEN) with women not using HC. Methods and Findings Eligible studies measured HC exposure and incident HIV infection prospectively using standardized measures, enrolled women aged 15-49 y, recorded [greater than or equal to]15 incident HIV infections, and measured prespecified covariates. Our primary analysis estimated the adjusted hazard ratio (aHR) using two-stage random effects meta-analysis, controlling for region, marital status, age, number of sex partners, and condom use. We included 18 studies, including 37,124 women (43,613 woman-years) and 1,830 incident HIV infections. Relative to no HC use, the aHR for HIV acquisition was 1.50 (95% CI 1.24-1.83) for DMPA use, 1.24 (95% CI 0.84-1.82) for NET-EN use, and 1.03 (95% CI 0.88-1.20) for COC use. Between-study heterogeneity was mild ([I.sup.2] < 50%). DMPA use was associated with increased HIV acquisition compared with COC use (aHR 1.43, 95% C11.23-1.67) and NET-EN use (aHR 1.32, 95% C11.08-1.61). Effect estimates were attenuated for studies at lower risk of methodological bias (compared with no HC use, aHR for DMPA use 1.22, 95% CI 0.99-1.50; for NET-EN use 0.67, 95% CI 0.47-0.96; and for COC use 0.91,95% CI 0.73-1.41) compared to those at higher risk of bias ([p.sub.interaction] = 0.003). Neither age nor herpes simplex virus type 2 infection status modified the HC-HIV relationship. Conclusions This IPD meta-analysis found no evidence that COC or NET-EN use increases women's risk of HIV but adds to the evidence that DMPA may increase HIV risk, underscoring the need for additional safe and effective contraceptive options for women at high HIV risk. A randomized controlled trial would provide more definitive evidence about the effects of hormonal contraception, particularly DMPA, on HIV risk., Introduction There is ongoing debate whether hormonal contraception (HC) increases the risk of HIV acquisition [1-4]. Strong evidence for an association would have important implications for sexual and reproductive health, [...]
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- 2015
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20. Abortions in a hospital setting: hidden realities in Dar es Salaam, Tanzania
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Justesen, Aafke, Kapiga, Saidi H., and Asten, Henri A.G.A. van
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Dar es Salaam, Tanzania (City) -- Health aspects ,Abortion services -- Research ,Abortion -- Research ,Family and marriage ,Geography ,Social sciences - Published
- 1992
21. Risk factors for HIV infection among women in Dar-es-Salaam, Tanzania
- Author
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Kapiga, Saidi H., Shao, John F., Lwihula, George K., and Hunter, David J.
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Tanzania -- Health aspects ,HIV infection -- Risk factors ,Women -- Health aspects ,Health - Abstract
Use of an intrauterine device (IUD) contraceptive may be associated with a higher risk of HIV infection in women. Researchers in Dar-es-Salaam, Tanzania interviewed 2,285 women between the ages of 15 and 48 at family planning clinics to evaluate risk factors for HIV infection. The incidence of HIV infection among these women was 11.5%. Fifty percent of the HIV-positive women were married. Employment outside the home and a higher level of education of both the women and their husbands were associated with a greater likelihood of HIV infection. Women whose husbands had other sex partners were also at greater risk, as were women who had multiple partners and women with sexually transmitted diseases. Housewives and young women between 15 and 19 years old had the lowest prevalence of HIV infection. There was no significant association between HIV infection and either oral or injectable contraceptive use. Women who used IUDs, however, were 2.5 times more likely to be HIV positive.
- Published
- 1994
22. Bacterial vaginosis associated with increased risk of female-to-male hiv-1 transmission: a prospective cohort analysis among African couples
- Author
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Cohen, Craig R., Lingappa, Jairam R., Baeten, Jared M., Ngayo, Musa O., Spiegel, Carol A., Hong, Ting, Donnell, Deborah, Celum, Connie, Kapiga, Saidi, Delany, Sinead, and Bukusi, Elizabeth A.
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Vaginosis -- Physiological aspects -- Development and progression ,Disease transmission -- Research ,HIV infection -- Physiological aspects -- Risk factors ,Biological sciences - Abstract
Background: Bacterial vaginosis (BV), a disruption of the normal vaginal flora, has been associated with a 60% increased risk of HIV-1 acquisition in women and higher concentration of HIV-1 RNA in the genital tract of HIV-1-infected women. However, whether BV, which is present in up to half of African HIV-1-infected women, is associated with an increase in HIV-1 transmission to male partners has not been assessed in previous studies. Methods and Findings: We assessed the association between BV on female-to-male HIV-1 transmission risk in a prospective study of 2,236 HIV-1-seropositive women and their HIV-1 uninfected male partners from seven African countries from a randomized placebo-controlled trial that enrolled heterosexual African adults who were seropositive for both HIV-1 and herpes simplex virus (HSV)-2, and their HIV-1-seronegative partners. Participants were followed for up to 24 months; every three months, vaginal swabs were obtained from female partners for Gram stain and male partners were tested for HIV-1. BV and normal vaginal flora were defined as a Nugent score of 7-10 and 0-3, respectively. To reduce misclassification, HIV-1 sequence analysis of viruses from seroconverters and their partners was performed to determine linkage of HIV-1 transmissions. Overall, 50 incident HIV-1 infections occurred in men in which the HIV-1-infected female partner had an evaluable vaginal Gram stain. HIV-1 incidence in men whose HIV-1-infected female partners had BV was 2.91 versus 0.76 per 100 person-years in men whose female partners had normal vaginal flora (hazard ratio 3.62, 95% CI 1.74-7.52). After controlling for sociodemographic factors, sexual behavior, male circumcision, sexually transmitted infections, pregnancy, and plasma HIV-1 RNA levels in female partners, BV was associated with a greater than 3-fold increased risk of female-to-male HIV-1 transmission (adjusted hazard ratio 3.17, 95% CI 1.37-7.33). Conclusions: This study identified an association between BV and increased risk of HIV-1 transmission to male partners. Several limitations may affect the generalizability of our results including: all participants underwent couples HIV counseling and testing and enrolled in an HIV-1 prevention trial, and index participants had a baseline CD4 count $250 cells/mm3 and were HSV-2 seropositive. Given the high prevalence of BV and the association of BV with increased risk of both female HIV-1 acquisition and transmission found in our study, if this association proves to be causal, BV could be responsible for a substantial proportion of new HIV-1 infections in Africa. Normalization of vaginal flora in HIV-1-infected women could mitigate female-to-male HIV-1 transmission. Trial Registration: ClinicalTrials.com NCT00194519 Please see later in the article for the Editors' Summary., Introduction Worldwide, an estimated 33.3 million people are infected with HIV-1, 60% in sub-Saharan Africa, where women account for the majority of those infected [1]. Antiretroviral therapy (ART), through reducing [...]
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- 2012
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- View/download PDF
23. Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections
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Schmid, George P, Buve, Anne, Mugyenyi, Peter, Garnett, Geoff P, Hayes, Richard J, Williams, Brian G, Calleja, Jesus Garcia, De Cock, Kevin M, Whitworth, James A, Kapiga, Saidi H, Ghys, Peter D, Hankins, Catherine, Zaba, Basia, Heimer, Robert, and Boerma, J Ties
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Injections, Intramuscular -- Adverse and side effects ,Sexual intercourse -- Health aspects ,HIV infection -- Risk factors ,HIV infection -- Care and treatment - Published
- 2004
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