Objective
This proposal is designed to be complementary to the existing Mwanza Region AIDS/STD Intervention programme, funded by the AIDS Task Force of the EC (DGVIII) and the British ODA, which seeks to determine the impact of a population-based STD control programme on the incidence of HIV infection in a rural area. The proposed complementary studies include:
(a) Determination of the impact of the intervention on the prevalence and incidence of Stds through (i) additional data collected from a cohort of 12,000 adults of both sexes followed over two years; (ii) quarterly follow-up of a sub-cohort of 1,200 males; (iii) repeated surveys of women attending twelve antenatal clinics. (b) Case-control studies of risk factors for HIV infection and other Stds, including detailed sexual behaviour data, in (i) prevalent cases of infection at the baseline survey and matched controls; (ii) seroconverters over a two-year period and matched controls. (c) Aetiology studies in 200 patients attending an STD clinic in Mwanza town with genital ulcer syndrome.
(d) Studies of asymptomatic carriage of H ducreyi in (i) 25 commercial sex workers followed prospectively; and (ii) 100 patients attending the STD clinic without clinical evidence of genital ulceration. (e) Field testing of a new serological test for H ducreyi, by (i) correlating the results of serology and culture in STD clinic attenders; and (ii) prospective follow-up of chancroid patients to determine the dynamics of the serological response.
These studies will substantially increase the value of results from the existing programme by evaluating the impact of the intervention on STD rates, by providing additional data on risk behaviours associated With HIV and other Stds, and by giving valuable information on the epidemiology. aetiology and diagnosis of Stds in a rural African population.