Sexually transmitted diseases in prostitutes in Moshi and Arusha, Northern Tanzania

Abstract

Sexually transmitted diseases are thought to be important in facilitating transmission of HIV in sub-Saharan Africa. This study reports the prevalence of several sexually transmitted diseases in 106 prostitutes in Arusha and Moshi Northern Tanzania. The seroprevalence of HIV was 73% compared with 3% for local blood donors. Over half (51%) of the subjects had evidence of N. gonorrhoeae infection. Seventy-four per cent had a positive TPHA and 27% a positive RPR. Of 47 subjects tested 12 (25%) had Chlamydia trachomatis antigen detected in endocervical swabs. No significant statistical association was found between the presence of any of the STDs investigated and HIV seropositivity.

PIP: In the early 1990s, health workers spoke with, examined, and took blood samples from 106 low income 17-70 year old prostitutes mainly from the Haya tribe in their homes in the towns of Moshi in Kilimanjaro Region and Arusha in Arusha Region in Northern Tanzania (45 from Moshi and 61 from Arusha) to determine the prevalence of sexually transmitted diseases (STDs) and HIV. Number of sexual contacts/day ranged from 10-20. 40% did not use condoms at all even though they regularly received condoms as part of a health education campaign. 73% tested positive for HIV which is considerably higher than the seroprevalence in the general population in 1989 (.1-3%). Only 20% thought that they presently had an STD when actually 22-82% had at least 1 STD. About 50% tested positive for syphilis, 47% for gonorrhea, and 25% in Arusha for chlamydia. No significant association existed between HIV seropositivity and STD prevalence. Another study showed that HIV seroprevalence among the general population had only slightly increased since 1987 which suggests that these prostitutes experienced high HIV seroprevalence earlier in the epidemic. These prostitutes represented a reservoir for STDs including HIV. Unless condom use increases among these women, HIV will spread to the general population. Health education campaigns should expand beyond just provision of condoms and find other means to effectively target these women.