HIV infection and asymptomatic sexually transmitted infections in a rural South African community

The objective was to determine the prevalence of HIV and other sexually transmitted infections STIs in a rural community. A population based survey of adults in 110 homesteads was conducted in 1995. A questionnaire on demographics, sexual practices and history of STDs was administered. Neisseria gonorrhoeae and Chlamydia trachomatis infections were detected using ligase chain reaction LCR assay of urine. The seroprevalence of syphilis rapid plasma reagin RPR and Treponema pallidum haemagglutination assay TPHA and HIV infection ELISA was determined. Among 259 subjects the prevalence of HIV was 10.5 , N. gonorrhoeae 4.5 , C. trachomatis 6.1 and active syphilis 8.8 . All infections were asymptomatic. Forty per cent of sexually active men had more than one concurrent sexual partner. Only 14 of subjects had ever used condoms. The STI epidemic is being promoted by high levels of asymptomatic infections, high partner concurrency and low condom use.