HIV infection and sexual behaviour among women with infertility in Tanzania: A hospital-based study

Background. Infertility is common in Africa, but virtually no data exist on HIV prevalence among infertile women. Mainly anthropological studies in Africa have shown that infertile women have higher risks of marital instability and possibly also have more sexual partners than fertile women. Method. This study was conducted in a hospital in northwest Tanzania during 1994 and 1995. Women presenting themselves with infertility problems of the outpatient clinic were interviewed, examined and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, were taken as a control group. The analysis was limited to women greater than or equal to 24 years. In total, 154 infertile and 259 fertile women were included in the study. Results. HIV prevalence was markedly higher among infertile women than among fertile women: 18.2% and 6.6% respectively (adjusted odds ratio [OR] for age, residence and occupation 2.7; 95% confidence interval [CI] : 1.4-5.3). Data on past sexual behaviour showed that infertile women had more marital breakdowns, more lifetime sexual partners and a higher level oi exposure to sexually transmitted diseases (STD). Conclusion. Women with fertility problems appear to have higher HIV prevalence, which justifies more attention for such women in the context oi AIDS programmes. In addition, caution is needed when using sentinel surveillance data from antenatal clinics to monitor HIV prevalence.