AEGiS-13IAC: Declining sexually transmitted disease and HIV prevalences among antenatal and family planning clinic attenders in Nairobi, Kenya, from 1992-1999.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Declining sexually transmitted disease and HIV prevalences among antenatal and family planning clinic attenders in Nairobi, Kenya, from 1992-1999.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC727)

Moses S, Ngugi EN, Costigan A, Kariuki C, Ronald AR, MacLean I, Plummer FA
S. Moses, University of Manitoba, Dept. of Medical Microbiology, 730 William Avenue, Winnipeg, Manitoba R36, Canada, Tel.: +1 204 789 3357, Fax: +1 204 789 3926, E-mail: smoses@cc.umanitoba.ca

BACKGROUND: An HIV/STD surveillance program was established in 3 health centres in Nairobi to monitor the impact of an intervention program in the clinics and their catchment areas consisting of: 1) improved primary level STD services; and 2) peer-mediated community HIV/STD prevention programs for female sex workers.

METHODS: Six survey rounds were completed from 1992-1999, with comparable samples of about 300 female antenatal and family planning clinic attenders per centre per round. A questionnaire was administered, cervical specimens were collected for gonorrheal culture, and blood was drawn for syphilis, HIV & chlamydia serology.

RESULTS: Trends in STD/HIV prevalence are shown. Specimens are still being analyzed for chlamydia serology (to be completed by Feb. 2000). Declines are statistically significant by chi-square test for trend for gonorrhea (P > 0.001), chlamydia (P = 0.001), syphilis (P > 0.001), and HIV in women under 20 from Surveys 2-6 (P = 0.02). Survey Gonorrhea Chlamydia Syphilis HIV (all) HIV (>20 years) 1 (3/92-9/92) 5.3% 30.1% 5.4% 14.7% 15.0% (45/843) (72/239) (46/846) (124/846) (26/173) 2 (10/92-10/93) 5.0% 26.7% 5.2% 18.9% 20.8% (48/957) (85/318) (50/967) (183/968) (42/202) 3 (11/93-11/94) 3.6% 20.6% 4.5% 18.0% 20.7% (33/926) (152/739) (42/934) (168/935) (44/213) 4 (12/94-3/96) 3.6% 3.8% 17.4% 14.3% (33/911) (35/912) (159/912) (27/189) 5 (5/96-4/97) 3.9% 3.7% 17.9% 15.0% (35/909) (34/915) (164/916) (36/240) 6 (2/99-12/99) 1.7% 2.5% 18.7% 14.0% (15/891) 2.5% 18.7% 14.0% Behavioural changes were also observed, including significant declines in the proportion of women reporting selling sex, declines in numbers of reported sex partners, and increases in condom knowledge and use.

CONCLUSION: The prevalences of the "conventional" STDs, and HIV infection in young women have declined, probably due in part to these interventions. Surveillance will continue to monitor whether these trends persist.

Keywords: AEGIS, Sexually Transmitted Diseases, Prevalence, HIV Infections, Condoms, Family Planning Services, Ambulatory Care Facilities, Syphilis, Gonorrhea, HIV Seropositivity, Chlamydia Infections, Data Collection, Kenya, Human, Female
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