DECLINING SEXUALLY TRANSMITTED DISEASE AND HIV PREVELANCES AMONG ANTENATAL CLINIC (ANC) ATTENDERS IN NAIROBI, KENYA, FROM 1992 – 2001

S Moses¹, EN Ngugi², A Costigan^1,2, C Kariuki², FA Plummer^1
1University of Manitoba, Winnipeg, Manitoba; ²University of Nairobi, Nairobi, Kenya

Background: An HIV/STD surveillance program was established in three health centres to monitor the impact of an intervention program in the clinics and their catchment areas consisting of: 1) improved primary level clinic-based STD treatment and prevention services; and 2) community HIV/STD prevention programs for female sex workers.
Methods: Eight survey rounds were completed from 1992-2001 with samples of approximately 200-300 female ANC attenders per centre per round. A questionnaire was administered, cervical specimens were collected for gonorrheal culture, and blood was drawn for syphilis, HIV and chlamydia serology.
Results: Trends in STD and HIV prevalence are shown. Declines over time are statistically significant (P<0.001, Chi-square test for trend) for gonorrhea, chlamydia and syphilis, and for HIV in women under 20 from Surveys 2-8. Behavioural changes were also observed, including significant declines in women reporting selling sex, declines in numbers of reported sex partners, and increases in condom knowledge and use.

Conclusion: The prevalences of the “conventional” STDs, and HIV infection in young women have declined, probably due at least in part to these interventions.