Population-based study of HIV-1 infection in 4,086 subjects in northwest Tanzania

A population-based HIV-1 seroprevalence survey of 4,086 individuals, aged 15-49 years, in the North Mara district of Tanzania from rural, periurban, and urban areas, including high-risk (prostitutes, and co-workers) individuals, was performed in 1989 and 1990. The overall seroprevalence was 7.3% (95% confidence interval, 6.5-8.1), with a gradient of seropositivity from high-risk 13.0% (9.1, 16.8), urban 8.8% (7.6, 10.0), periurban 6.5% (4.7, 8.4), to rural 2.6% (1.6, 3.7) subjects. Adjusted for population group, HIV-1 seroprevalence was significantly elevated for men over age 24 and for women 20-34 years old, while age-specific prevalence rates were similar for men and women in the rural area. Recent treponemal infection, measured by the rapid plasma reagin test, was not associated with HIV-1 seropositivity in men or women. These data suggest a growing HIV-1 epidemic paralleling rising rates in other rural areas of Africa distant from areas that have been previously recognized as having high prevalence.