STD Treatment Program Lowers Risk of HIV Infection in Tanzania

Abstract

From November 1991 through December 1994 six communities in the Mwanza region of Tanzania participated in a program designed to improve the local treatment of sexually transmitted disease (STD). The program involved improving the management of STD cases at rural health visits through training health center staff providing a regular supply of drugs with which to treat STDs conducting periodic supervision visits and holding community health education sessions on seeking treatment for STDs. The intervention communities were matched with six control communities. A total of 12537 men and women aged 15-54 from all 12 communities were surveyed at baseline and 8825 were seen at follow-up two years later. At baseline the rates of HIV prevalence in the intervention and comparison communities were 3.8% and 4.4% respectively. 11362 cases of STD were treated in local health clinics participating in the program during the two years of follow-up. The intervention seems to have reduced the risk of STD infection as well as the risk of HIV infection. At the two-year follow-up HIV infection rates were found to be 42% lower in the intervention communities than in the control communities with the impact of the intervention particularly pronounced among women aged 15-24 years and men aged 25-34. Since there appears to have been no change in sex behavior over the period the one may conclude that the STD intervention which shortened the duration of infection most likely lowered the incidence of HIV.