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NATIONAL HIV/AIDS RESEARCH AND BEST PRACTICES CONFERENCE - page 100 / 103

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F.3.HIV and STD prevalence in rural Malawi

Joaki, G, Watkins S, Banda T, Onyango F, Martinson F, Bignami S, Chilongozi D, Renier G, Thornton R, Smith K, Hoffman I

Objectives: The majority of the Malawi HIV and STD prevalence data is clinic based. The objective of this study was to determine the population-based prevalence of HIV and traditional STDs in 3 rural sites in Malawi.

Methods: In 2004, a comprehensive sampling of adolescents and adults who reside in rural areas surrounding Machinji, Balaka and Rhumphi and gave informed consent, were tested for HIV by saliva EIA/Western Blot, and trichomonas (TV), gonorrhea (GC) and chlamydia (CT) by PCR.  Women provided self-administered vaginal swabs and men provided urine for testing of the STDs. All participants with a positive STD were provided treatment, and all HIV tested were provided pre-and post-test counseling. Data for Machinji is pending.

Results:

HIV

GC

CT

TV

Balaka

  men

34/492  (6.9%)

2/467   (0.4%)

0/467  (0.0%)

n/a

  women

55/577  (9.5%)

54/555 (9.7%)

5/555  (0.9%)

14/555  (2.5%)

Rumphi

  men

17/475  (3.6%)

2/446  (0.5%)

1/446  (0.2%)

n/a

  women

31/533  (5.8%)

8/492  (1.6%)

0/492  (0.0%)

4/492  ((0.8%)

Conclusions:  Except for GC in Balaka women, the population-based traditional STDs were low in these rural areas. As predicted, the HIV prevalence among women was higher than among men, but was substantially lower than the reported rural ANC data representing these areas.

Recommendations:  Women in rural Balaka should receive repeat GC screening and counseling. Further analysis is warranted comparing this HIV data and the official rural ANC data. Women in rural Malawi remain a vulnerable population and real efforts should be make to improve the status and lower the risk of rural women.

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