Geographical variations in the prevalence of HIV and other sexually transmitted infections in rural Tanzania.

The prevalence and incidence of HIV and other sexually transmitted infections (STIs) were recorded in two lake-island and eight rural mainland communities in Mwanza, Tanzania. The prevalence and incidence of HIV and syphilis were lower on the islands, but this pattern was not seen for herpes simplex virus type-2, gonorrhoea, chlamydia, male urethritis or antenatal prevalences of Trichomonas vaginalis. Island men reported fewer sexual partners than mainland men but no differences were found for women. Island men were more likely to be circumcised, island women less mobile and there were differences in marriage patterns. Possible explanations for the differences in HIV and syphilis include: slower introduction of HIV into the islands because of geographical isolation, more core-group sexual contact on the mainland, higher prevalence of male circumcision on the islands and differences in marital status. Differences in transmission dynamics may lead to geographical patterns that vary between STIs.