Case Studies of Acute HIV-1 Infections Acquired While Visiting Subsaharan Africa.

Abstract

“They generally behaved like pigs, drank too much, and, raped the local girls wherever we moored on the African Coast.” This was written in the journal of a Dutch vicar while on his way to the Dutch Indies aboard a ship ofthe United Dutch Indies Company -Verenigde Oostindie Compagnie (VOC) in 1791.’ Although a visit to subSaharan Mica has always been accompanied by certain risks to our health, sexually transmitted diseases have always been abundant on this continent.The advent of the AIDS epidemic has greatly added to the dangers confronting sexually active visitors. Even well informed travelers appear to run enormous risks when they practice unsafe sex. A Dutch survey of 1968 participants, 1122 men and 846 women, has shown that 89 men (7.9%) and 18 women (2.1%) lived with an African partner and that 344 men (30.7%) and 111 women (1 3.1%) had heterosexual contact with African partners. Only 22.3% (men) and 18.6% (women) of these casual sexual contacts were protected with a condom.’ This is one of the reasons why the International Society of Travel Medicine called for a resolution to eliminate sex t o u r i ~ m . ~ Surprisingly, no cases of acute HIV-1 or HIV-2 infection related to traveling in the tropics could be traced in the literature. Because of the medical and social consequences of AIDS infection, we believe that presenting case reports can make physicians more aware of the importance of including acute HIV infection in differential diagnoses. To underscore the importance of this recommendation, three case-reports are presented.These cases show the dramatic impact on persons who acquire HIV infection while traveling or working in Africa.