Biomedical subjects

M T Mbizvo

Publications and source records attributed to M T Mbizvo.

At least 19 recordsLinked to original sources

PubMed2006

Acceptability of an injectable male contraceptive regimen of norethisterone enanthate and testosterone undecanoate for men.

BACKGROUND: We assessed attitudes towards and acceptability of male hormonal contraception among volunteers participating in a clinical trial of a prototype regimen, consisting of progestin and testosterone injections. METHODS: After completing screening, eligible men were randomly assigned to the no-treatment group (n = 40) or to receive injections of norethisterone enanthate and testosterone undecanoate or placebo at different intervals (n = 50) according to a blocked randomization list. They underwent self-administered questionnaires. RESULTS: The average age of the participants was approximately 28 years; most were involved in a stable relationship and had no children. Ninety-two percentage of the respondents thought that men and women should share responsibility for contraception and 75% said they would try a hormonal contraceptive if available. At the end of the treatment phase, 66% of the participants said that they would use such a method, and most rated its acceptability very highly; none reported it to be unacceptable. The injections themselves were indicated as the biggest disadvantage. No significant changes in sexual function or mood states were detected among the men who underwent hormone injections. CONCLUSIONS: The contraceptive tested in this study was well accepted by the participants over the course of 1 year.

Adult↗

PubMed2004

Desire for a future pregnancy among women in Zimbabwe in relation to their self-perceived risk of HIV infection, child mortality, and spontaneous abortion.

In a background of very high prevalence of human immunodeficiency virus (HIV) infection among women of childbearing age and the increasing demand for treatment to prevent mother-to-child transmission, we investigated the desire for a future pregnancy among women in Zimbabwe in relation to (1) self-perceived risk of HIV infection, (2) child mortality, and (3) spontaneous abortion. A random cross-sectional sample of 2250 ever-married women aged 15-49 years was selected from 6,828 households in rural and urban Zimbabwe. The sample was representative of the geographic distribution of women. One eligible subject was selected per household for a structured interview on factors associated with the desire for future pregnancy. Overall, 54% of the participants desired to get pregnant in future; 55% perceived themselves at high risk for HIV infection; 6% reported the death of at least one child less than the age of 5 years in the last 5 years; and 12% reported at least one spontaneous abortion in the last 5 years. In multiple logistic regression analysis, reporting at least one child's death (OR = 1.77; 95% CI 1.13-2.78) and at least one spontaneous abortion in the last 5 years (OR = 1.81; 95% CI 1.08-3.04) were significantly associated with a higher desire to get pregnant; however, high self-perceived risk for HIV infection was not (OR = 0.85; 95% CI 0.67-1.09). High self-perceived risk for infection with HIV was not associated with a lower desire for a future pregnancy among women in Zimbabwe in a high-prevalence area. In fact, our data suggest an increased desire for future pregnancy to replace childhood deaths or spontaneous abortions that may result from HIV infection. Voluntary HIV testing services are challenged with balancing counseling messages on the strong desire for children, the risk of mother-to-child transmission, and poor fetal outcomes. Further research is needed to explore utilitarian-economic, social, and psychological values attributed to children by women and their partners. The involvement of men as partners in childbearing should be explored, as their desire for children may be the primary barrier to protective behavior change among women.

Abortion, Spontaneous↗

PubMed2001

Feasibility of surveillance of changes in human fertility and semen quality.

There is concern that male fertility is declining, but this is difficult to study because few men volunteer for studies of semen quality, and recruitment bias may over-represent the subfertile. The Human Reproduction Programme of the World Health Organization developed a protocol for multicentre studies of fertility involving a questionnaire for pregnant women to obtain time to pregnancy (TTP): the number of menstrual cycles taken to conceive. Male characteristics and semen quality will be determined in a subset of the partners. Our aim was to validate the TTP questionnaire, and to examine potential recruitment bias and feasibility of conducting large-scale surveillance of fertility. The questionnaire was administered to 120 pregnant women (16-32 weeks). Validation included internal reliability by consistency of responses, test-re-test reliability by repeat administration (20 women) and accuracy by comparison of gestational age from first antenatal ultrasound and menstrual dates. Internal reliability was high. Agreement between categorical responses on re-testing was very good (k > 0.8). In both the re-test and gestational age analysis, differences in TTP of 1 cycle were found (standard deviation <0.25 cycles). In this small pilot study there was no evidence of recruitment bias. Response rates indicate the feasibility of surveillance of fertility in large maternity centres.

Adult↗

PubMed2001

HIV-1 seroconversion incidence following pregnancy and delivery among women seronegative at recruitment in Harare, Zimbabwe.

OBJECTIVE: To estimate the incidence of HIV seroconversion among women following pregnancy and delivery. DESIGN: A prospective cohort of women who were HIV negative at recruitment on first antenatal care visit. MATERIALS AND METHODS: Pregnant women were invited to undergo voluntary confidential HIV counselling and blood draw for HIV testing during the first antenatal care visit as part of a prospective study of mother-to-child transmission of HIV-1. Repeat tests were conducted at delivery, six weeks post partum and at three monthly intervals until 24 months or on termination due to subsequent pregnancy, death or loss to follow up. Logistic regression modelling was used to determine independent predictors of HIV seroconversion. RESULTS: Among 372 HIV negative pregnant women who were enrolled, 66 seroconverted during follow up, resulting in a sero-incidence of 4.8 per 100 person years (95% confidence interval [CI], 3.1 to 6.5). Women who did not seroconvert during the time of pregnancy or follow up were significantly more likely to have used a condom with their partners (OR = 0.68, 95% CI = 0.47 to 0.99). Women aged 17 years and below had the highest seroconversion incidence (6.25%) followed by those aged 18 to 19 years (5.42%). Women who seroconverted and those who were HIV positive at recruitment were more likely to be married. Lack of education by the partner of a pregnant woman constituted a significant risk factor for HIV seroconversion (OR = 2.8; 95% CI = 1.1 to 11.0). CONCLUSIONS: There is a high HIV seroconversion incidence among women during pregnancy and following delivery, especially those aged 19 years and below. Being married does not protect the women from the risk of HIV seroconversion. Strategies for HIV prevention should target pregnant women and their partners.

Adolescent↗

PubMed2001

Promoting safe motherhood in the community: the case for strategies that include men.

Although a decade has now passed since the launching of the Safe Motherhood Initiative, maternal mortality continues to be the health indicator showing the greatest disparity between developed and developing countries. Recently revised WHO and UNICEF figures indicate that an estimated 90% of the 585,000 worldwide maternal deaths that occur each year take place in sub-Saharan Africa and Asia. In terms of the lifetime risk of maternal death, this disparity remains striking: 1 in 12 women in parts of sub-Saharan Africa, compared with 1 in 4,000 women in Northern Europe. In addition, for every woman who dies, an estimated 16-17 will suffer from pregnancy-related complications. Research suggests that, in addition to biomedical interventions and the strengthening of health care services, improving awareness of obstetric complications among members of a pregnant woman's immediate and wider social network is an important step in improving her chances of survival when such complications occur. Many of the interventions implemented so far have focused exclusively on improving women's knowledge and practices as they relate to maternal health issues. Nevertheless, it is now increasingly being recognised that the actions required to achieve improvements in reproductive health outcomes in general, and maternal health in particular, should involve communities in the process and encourage men's active participation. Despite this, very few studies on risk perceptions or interventions to raise community awareness of obstetric risk factors, their complications and their consequences have targeted men. The present article argues for the development and testing of risk awareness interventions, which, in addition to women, target men in their familial and social roles within communities and as workers within health care services as a means of improving maternal health outcomes.

Africa↗

PubMed2000

Effect of intravaginal practices on the vaginal and cervical mucosa of Zimbabwean women.

OBJECTIVES: Lesions on the vaginal and cervical mucosa may facilitate transmission of HIV and other sexually transmitted diseases (STDs). We evaluated the relationship between intravaginal practices and the presence of colposcopic lesions in Zimbabwean women. METHODS: Users and nonusers of intravaginal practices were seen at enrollment, and at 1 and 6 months. Interviewing, counseling, and pelvic and colposcopic examinations were performed at each study visit. Specimens were collected at enrollment and 6 months. RESULTS: Colposcopic lesions were found at least once in 83% of the participants (n = 162), and in 66% of all exams (n = 430). Most lesions were classified as related to infection with human Papillomavirus (HPV) (58%) or another pathogen (20%), but 11% of lesions could have been caused by intravaginal practices (signal lesions). Intravaginal practices were not associated with an increased incidence in signal lesions (95 and 124 lesions per 100 person-years of follow-up for users and nonusers respectively; p = .290), nor with the presence of signal lesions in multivariate baseline (odds ratio [OR], 1.32; 95% confidence interval [CI], 0.37-4.72; p = .666) and six month transition models (OR, 1.67; 95% CI, 0.59-4.70; p = .333). CONCLUSIONS: No associations between intravaginal practices and colposcopic lesions were found in this study. However, the potential effect of intravaginal practices on the cervical and vaginal mucosa, and on subsequent HIV and STD transmission, warrants further study. The usefulness of colposcopy as a research tool in areas with high prevalences of HIV and HPV is questioned.

Adolescent↗

PubMed2000

Feasibility of surveillance of changes in human fertility and semen quality.

To show that male fertility is declining is not simple. Few men volunteer and recruitment bias may lead to over-representation of the subfertile. Semen analysis has errors arising from counting and poorly standardized criteria, which may be overcome by automation. Time to pregnancy (TTP)-the number of menstrual cycles taken to conceive-measures fertility and allows male recruitment bias to be estimated. We review automated measurement of sperm concentration, motility and morphology and present a preliminary report on a study to assess a retrospective TTP questionnaire, recruitment bias and feasibility for large-scale surveillance of fertility.

Feasibility Studies↗

PubMed2000

Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women.

One hundred sixty-nine Zimbabwean women were studied to determine whether the use of intravaginal practices (cleaning with the fingers, wiping the vagina, and inserting traditional substances) are associated with disturbances of vaginal flora and acquisition of sexually transmitted diseases (STDs). Subjects were interviewed and received counseling and a pelvic examination at enrollment, 1 month, and 6 months, and vaginal specimens were collected at enrollment and at 6 months. Users were more likely than nonusers to have vaginal flora disturbances but were not more likely to acquire an STD (relative risk [RR], 2.15; P=.188). Certain vaginal flora disturbances were associated with increased STD incidence and HIV prevalence. The absence of lactobacilli from the vaginal flora was associated with being positive for human immunodeficiency virus in baseline (odds ratio [OR], 0.24; P=.001) and 6-month transition multivariate models (OR, 0.39; P=.025). The presence of clue cells at baseline was associated with a higher incidence of STDs (RR, 1. 94; P=.025).

Adult↗

PubMed2000

Report of sexually transmitted diseases by HIV infected men during follow up: time to target the HIV infected?

OBJECTIVES: To compare the rate of self reported sexually transmitted diseases (STDs) among HIV infected men with men who remained HIV negative during follow up of a Harare male factory cohort. METHODS: Male factory workers were offered enrolment and behavioural data were collected at entry then every 6 months, along with HIV testing. Self report of STDs was used to calculate incidence per 100 person years. Cox proportional hazards models examined independent risk factors for STDs, with hazard ratios (HRs). RESULTS: At entry 20% of men were HIV infected and 11% reported STDs in the previous year. A total of 2777 (82%) of 3383 men enrolled were followed at least once. Compared with men who remained HIV negative, seroconverters had the highest incidence of STDs (16.8 per 100 person years; IRR = 3.3, 95% CI = 2.5-4.3); men enrolled HIV positive also reported higher STD incidence (14.5 per 100 person years, IRR = 2.8; 95% CI 2.3-5.5). Among HIV positive men, the only independent risk factor for report of urethral discharge was history of multiple partners (HR = 10, 95% CI 1.4-73.2). CONCLUSION: HIV positive men reported threefold higher incidence of STDs than HIV negative men, many related to high risk sexual behaviour.

Adult↗

PubMed2000

Generational differences in male sexuality that may affect Zimbabwean women's risk for sexually transmitted diseases and HIV/AIDS.

OBJECTIVE: To determine generational differences in male sexuality, which could predispose men's female sexual partners to STDs/HIV. DESIGN: Cross-sectional study. SETTING: Harare, Zimbabwe. SUBJECTS: Three hundred and ninety seven male adults aged eighteen years and above. MAIN OUTCOME MEASURES: Number of sexual partners, condom use, likelihood of sharing information on HIV status with wife or with other sexual partners, preference for women with dry vaginas prior to sex and discussion about sexual satisfaction with wife or with girl friend. RESULTS: Fewer men in the 27-39 year age group when compared to men aged 18-26 years (22.2% versus 28.9%) had two or more sexual partners. The greatest proportion of ever condom users were men aged 27-39 years, but this proportion was not significantly different from the proportion of ever condom users aged 18-26 years (76.5% versus 69.5%; Odds Ratio[OR] = 1.42, 95% Confidence interval [CI] 0.81-2.51). Men aged > or = 40 years (43.8%, OR = 0.34, 95% CI 0.20-0.84) were significantly fewer than men aged 18-26 years in ever use of condoms. In the event that they contracted HIV, 79.5%, 82.4% and 85.9% of men aged 18-26, 27-39 and 40 years and above respectively indicated that they would disclose their HIV status to their wives. On the other hand, men aged 18-26 years (56.8%), 27-39 years (54.0%) and > or = 40 years (53.1%) indicated that they would disclose their HIV status to girl friends or other sexual partners. Significantly, more men aged 40 years (OR = 2.23; 95% CI 1.19-4.18) and 27-39 years (OR = 1.82; 95% CI 1.00-3.32) in comparison to 18-26 year old men indicated their preference for women with dry vaginas prior to sex. The greatest proportion of men who discussed sexual satisfaction with their wives (85.7%) and girl friends or other sexual partners (23.5%) were aged 27-39 years. CONCLUSION: It is recommended that public health and behavioural scientists in Zimbabwe devote more time to understanding the intricacies of male sexual behaviour at different stages of life. This would provide the important insight needed to develop effective targeted interventions to reduce the spread of STDs/HIV in Zimbabwe.

Adolescent↗

PubMed1999

Evaluation of the prototype Roche DNA amplification kit incorporating the new SSK145 and SKCC1B primers in detection of human immunodeficiency virus type 1 DNA in Zimbabwe.

We assessed the sensitivity and specificity of a newly developed DNA PCR kit (Roche Diagnostic Corporation, Indianapolis, Ind.) that incorporates primers for all the group M viruses for the detection of human immunodeficiency virus (HIV) type 1 (HIV-1) infection in Zimbabwe. A total of 202 whole-blood samples from adults whose HIV status was known were studied. This included 100 HIV-1-positive and 102 HIV-1-negative samples selected on the basis of concordant results obtained with two enzyme-linked immunosorbent assay kits. The prototype Roche DNA PCR assay had a 100% sensitivity for the detection of HIV-1 DNA and a specificity of 100%. We conclude that the new Roche DNA PCR kit is accurate for the detection of HIV DNA in Zimbabwean samples, in which HIV-1 subtype C dominates.

Adult↗

PubMed1999

AIDS related knowledge and sexual behaviour among commercial farm residents in Zimbabwe.

OBJECTIVE: To describe sexual behaviour among residents of commercial farms in Zimbabwe, their gender-specific differences; to examine implications of these for HIV/AIDS transmission. DESIGN: A cross sectional descriptive study. SETTING: Three commercial farming communities near Harare, Zimbabwe. SUBJECTS: Convenience sample of 218 adult (age 18+, or ever married) farm residents. MAIN OUTCOME MEASURES: Number of sexual partners, secondary sexual relationships outside marriage, condom ever-use, first sexual partner, sexually transmitted disease (STD) experience, unprompted knowledge of HIV. RESULTS: Knowledge of HIV transmission was high, with eight to 88% of respondents reporting various correct means of transmission. Males reported engaging in riskier behaviour than females, with 60% of currently married males (n = 81) reporting extra marital affairs compared to 4% of currently married females (n = 91) (OR: 4.02; 95% CI: 1.8 to 9.04). Males were more likely than females to report a second or further marriage (OR: 37.9; 95% CI: 16.01 to 92.1). Females were more likely than men to report first sexual partner as spouse. Fourteen percent of respondents had children of various ages outside their current union. Reported STD experiences under various circumstances were negligible with no differences by sex. CONCLUSION: While HIV/AIDS prevention measures largely rely on individual behavioural change, preventive efforts should also encompass differences in sexual behaviour between categories like male and female. Importantly, this will determine composition of preventive policy, but also allow a clearer determination of trends based on the gender-specific behaviours. There is also need for more research work that attends to determinants of reporting behaviour beyond aspects of reported behaviour per se.

Adolescent↗

PubMed1999

Beliefs about sexual relationships and behaviour among commercial farm residents in Zimbabwe.

OBJECTIVES: To describe beliefs of farm residents about sexual relationships and sexual behaviours within these relationships, as a basis for understanding how these beliefs may influence sexual behaviour; and to document gender differences in these beliefs. DESIGN: Cross sectional descriptive study. SETTING: Three commercial farms in Mashonaland Central Province, Zimbabwe. SUBJECTS: Purposive convenience sample of 218 adult (age 18+, or ever-married) residents on the commercial farms. MAIN OUTCOME MEASURES: Views towards celibacy, wife inheritance, condom use, infertility, extra-marital affairs. RESULTS: 85% of respondents felt marriage was a cushion against HIV/AIDS. The majority (87.6%) viewed wife inheritance as improper; 37.6% felt that it facilitated the spread of HIV. Sixty two percent viewed condom use in marriage as unacceptable, and the majority of respondents felt that infertility was a problem in a person's life, with men being less likely than women to indicate this (OR: 0.26; 95% CI: 0.10 to 0.67). Male respondents expressed greater ability than their female counterparts to take protective steps in the event of suspecting STD/HIV/AIDS in their spouse. More male than female respondents felt they could leave marriage against perceived risk of infection with HIV from their partner (OR: 2.20; 95% CI: 1.22 to 4.00). CONCLUSION: Perceptions of wife inheritance are positive when viewed against known ways of HIV transmission. There is need for further work to allow women to express their integrity as individuals in their relationship with men, as a strategy to promote their reproductive health. Determinants of condom acceptance need further understanding because condom use is one of the effective ways of curbing the spread of HIV/AIDS.

Adolescent↗

PubMed1999

Abortion: attitudes and perceptions of health professionals in Zimbabwe.

OBJECTIVE: To determine the attitudes of professional health workers (doctors, nurses, matrons, social workers and hospital administrators) to medically supervised abortion. DESIGN: Cross sectional study. SETTING: Randomly selected health institutions--urban as well as rural in the eight provinces of Zimbabwe. SUBJECTS: Males and females--age range 18 to 70 years. MAIN OUTCOME MEASURES: Perception of the problem of abortion by health professionals, their knowledge of the present abortion law and desire for change. RESULTS: The majority of doctors were supportive of medically supervised abortion (61.2%) while the nurses were divided 43.2% for and 42.0% against but 14.8% were undecided. The administrators and social workers were supportive. Of the doctors 75% felt that the present abortion law was restrictive and 55.6% supported change. All health professionals agreed that the majority of women who present for abortion treatment are single. The surprising finding was that it is knowledge of the dire complications of unsafe abortion that determines one's attitude to abortion rather than religion. CONCLUSION: By increasing single women's and adolescents' access to family planning services the incidence of unintended pregnancies which result in unsafe abortion with life threatening complications will be reduced. The present restrictive abortion laws which foster backstreet unsafe abortion need to be revised.

Abortion, Legal↗

PubMed1998

Estimating HIV incidence from age-specific prevalence data: comparison with concurrent cohort estimates in a study of male factory workers, Harare, Zimbabwe.

OBJECTIVE: To compare HIV incidence estimates from cross-sectional age-specific prevalence data with concurrent cohort estimates and to examine the sensitivity of the estimates to changes in age-categorization and survivorship assumptions. METHODS: Two previously described methods of estimating HIV incidence from cross-sectional prevalence data - the cumulative incidence and survival (CIS) and constant prevalence (CP) methods - are applied using data from a study of male factory workers in Harare, Zimbabwe. The methods are applied under two alternative groupings of the HIV prevalence data and under alternative survivorship assumptions: (a) Weibull distribution providing the best fit to the HIV prevalence data using the CIS method; (b) Weibull distribution matching data from an HIV natural history cohort study in Uganda; and (c) survivorship pattern as in (b) with survival periods reducing with increasing age at infection. Age-specific, age-standardized and cumulative HIV incidence estimates are calculated. The results are compared with concurrent longitudinal estimates from 3 years of follow-up of the Harare cohort (1993-1995). RESULTS: Age-standardized HIV incidence was estimated at 2.02 per 100 man years (95% CI, 1.57-2.47) in the cohort study. There was evidence of recent variability in HIV incidence in these data. Estimates from the cross-sectional methods ranged from 1.98 to 2.74 per 100 man years and were sensitive to changes in age-categorization of the HIV prevalence data and changes in survivorship assumptions. The cross-sectional estimates were higher at central ages and lower at older ages than the cohort estimates. The age-specific estimates from the CIS method were less sensitive to changes in age grouping than those from the CP method. CONCLUSIONS: HIV incidence remains high in Harare. Incidence estimates broadly consistent with cohort estimates can be obtained from single-round cross-sectional HIV prevalence data in established epidemics - even when the underlying assumption of stable endemic prevalence is not fully met. Estimates based on cross-sectional surveys should therefore be explored when reliable longitudinal estimates cannot be obtained. More data on post-HIV infection survivorship distributions in sub-Saharan Africa would facilitate the improvement of estimates of incidence based on cross-sectional surveys.

Adolescent↗

PubMed1998

Mortality in the first 2 years among infants born to human immunodeficiency virus-infected women in Harare, Zimbabwe.

Transmission of human immunodeficiency virus (HIV) and mortality was studied among infants of infected women in Zimbabwe. Of 367 infants born to HIV-infected women, 72 (19.6%) died compared with 20 (5.4%) of 372 infants of uninfected women (P < .01). Infection by HIV DNA polymerase chain reaction among infants who survived >7 days and died within 2 years could be assessed in 87% (58/67) of infants of infected women and 83% (5/6) of infants of uninfected women; transmission occurred in 40 of 58 infants. Among 27 infected infants tested at birth, 19 (70%), 5 (19%), and 3 (11%) were apparently infected via in utero, intrapartum or early postpartum, and late postpartum transmission, respectively. The majority of HIV-infected infants who died in the first 2 years of life were likely to have acquired in utero infection.

Adult↗

PubMed1998

Study on the origin of seminal leucocytes using split ejaculate technique and the effect of leucocytospermia on sperm characteristics.

The origin of seminal leucocytes and their biological significance were investigated in 76 whole ejaculate samples and 27 split ejaculate samples, obtained from patients attending the Zimbabwe Family Planning Council's Spilhaus Infertility Clinic at Harare. The leucocytes were more prevalent in fractions 1 and 2 than in fraction 3, implying that the testis, epididymis and prostate are the major sources of seminal leucocytes. The contribution from the seminal vesicles was minimal. An inverse relation is apparent between leucocyte count and sperm count (p < 0.01). The percentage of abnormal sperms was higher (p < 0.05) and the sperm motility poorer in leucocytospermic samples (p < 0.01). Fructose, the seminal vesicular marker, citric acid, the prostatic marker and alpha-glucosidase, the epididymal marker were not decreased in leucocytospermia. It is concluded that the epididymis and prostate are the major contributors of granulocytes in semen. Leucocytospermia affects sperm morphology and sperm motility but not the accessory sex gland functions. Probably these cytotoxic effects are mediated by hydrogen peroxide due to activation of seminal leucocytes. However, the presence of leucocytospermia in normozoospermic samples is indicative of the possible peaceful coexistence of leucocytes and sperms.

Adult↗

PubMed1998

Impact of HIV counselling and testing on HIV seroconversion and reported STD incidence among male factory workers in Harare, Zimbabwe.

OBJECTIVES: To assess the impact of HIV counselling and testing on HIV seroconversion and incidence of reported sexually transmitted diseases (STDs) among male factory workers in Harare, Zimbabwe. DESIGN: Prospective, observational study among men recruited to participate in a future workplace based AIDS prevention intervention. METHODS: Participants provided STD histories and blood for HIV antibody testing at enrolment and six month intervals during visits to factories. Participants received HIV test results, post test counselling, and free STD services at the project clinic. RESULTS: Between March 1993 and June 1995, 2,414 men were enrolled with 85% follow up. Overall HIV sero-incidence was 2.60 per 100 person-years; the incidence of reported STDs was 10.19 per 100 person-years. Men who obtained their HIV test results had significantly higher HIV sero-incidence and incidence of reported STDs compared to men who did not obtain their results (IRRs: 1.87, 3.47, respectively). Among men who obtained their HIV test results, a non-significant 40% decrease in HIV sero-incidence was observed after obtaining test results compared to before obtaining results (p = 0.18). The incidence of reported STDs, however, increased by 30% after obtaining HIV test results (p = 0.10). CONCLUSIONS: Decreased HIV sero-incidence in the face of increased reported STD incidence suggests that timely treatment of STDs may decrease the risk of acquiring HIV even in the absence of behaviour change. In populations with high rates of HIV and STDs, the greatest benefit of HIV counselling and testing may be achieved by simultaneously offering STD screening and treatment services.

AIDS Serodiagnosis↗