Abstract

PIP: The sex and age distribution of acquired immunodeficiency syndrome (AIDS) in Africa (i.e., a l:l male-female ration and a concentration in the 30-39-year age group) are similar to those recorded for other sexually transmitted diseases, both in developed and developing countries. In Africa, AIDS shows a pattern of heterosexual transmission, and prevalence rates are highest among younger, sexually active women who have sexual relations with older men. 61% of African women with AIDS compared with 36% of male victims are unmarried. Prostitutes have consistently shown the highest rates of human immunodeficiency virus (HIV) infection--27-88% in various studies. In most areas of Africa, female prostitutes and men and women with a history of multiple sex partners in the previous 5 years contribute the majority of AIDS cases. 35% of AIDS patients also report having had at least 1 sexually transmitted disease in the 3 years preceding diagnosis. The high correlation between HIV seropositivity and genital ulcers suggests that the disruption of genital epithelial integrity may promote the transmission of HIV infection during vaginal intercourse. 2 additional factors--blood transfusions and exposure to blood- contaminated needles and syringes--are amplifying the dissemination of AIDS into the general population of Africa. Encouraging are findings among prostitutes that HIV transmission can be eliminated by consistent condom use and significantly reduced even when condoms are used in only half of sexual encounters. Africa presents numerous cultural, social, and economic obstacles to the effective prevention and control of AIDS. Integration of programs aimed at reducing risk factors into existing health and educational projects is necessary, as is the full support of government agencies.