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The Women’s Health Study of Accra is a cross-sectional study designed to measure the burden of communicable and noncommunicable diseases in adult women residing in Accra, Ghana. This study assessed the prevalence rate of HIV and risk factors associated with HIV infection in 1,328 women age 18 years and older. The weighted overall HIV prevalence rate for women residing in Accra is 3.1%. The highest prevalence rate of HIV infections was identified in women age 25 to 29 years at 8.3%, OR (95%CI) 3.8 (1.68–8.33), P = 001. In addition to young age, other significant risk factors included sexually transmitted infection (STI) symptoms (OR 1.81 [1.14–2.87], P = 0.012) and mean number of lifetime sexual partners (P < 0.001). All HIV-positive women were sexually active. Other findings significantly associated with HIV-positive status included chills, oral lesions, tuberculosis, bloody sputum production, and intestinal parasite infections. There was a significant association with HIV-positive status and locality of residence in the city. There was no association with reported use of condoms, blood transfusions, surgery, reproductive health history including pregnancy or number of sexual partners, symptoms suggestive of AIDS, or self-perception of health. There was also no association with education level, religion, ethnicity, marital status, or socioeconomic level. This community-based study confirms the need to target young, sexually active women for HIV educational and preventive initiatives. A strong Ghanaian public health initiative to increase awareness of the risks of HIV and the link to STIs is critical at this time to prevent the further increase in HIV prevalence and the resultant HIV-associated illnesses.
Received October 18, 2004. Accepted for publication February 8, 2005.
Financial support: This work was supported by the World Health Organization, the U.S. Agency for International Development, and a Fulbright New Century Scholars Award (A.G.H.).
* Address correspondence to Rosemary B. Duda, M.D., M.P.H., Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts. E-mail: rduda{at}caregroup.harvard.edu
Authors’ addresses: Rosemary B. Duda, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, Telephone: 617-667-2169, Fax: 617-667-2978, E-mail: rduda{at}caregroup.harvard.edu. Rudolph Darko, Department of Surgery, Korle Bu Teaching Hospital, University of Ghana, Accra, Ghana, E-mail: rdarko{at}ug.edu.gh. Richard M. K. Adanu, Department of Obstetrics and Gyneacology, Korle Bu Teaching Hospital, University of Ghana, Accra, Ghana, E-mail: rmadanu{at}yahoo.com. Joseph Seffah, Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, University of Ghana, Accra, Ghana, E-mail: jseffah{at}yahoo.co.uk. John K. Anarfi, Institute for Statistical, Social and Economic Research, University of Ghana, Accra, Ghana, E-mail: jkanarfi{at}isser.ug.edu.gh. Shiva Gautam, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, E-mail: sgautam{at}bidmc.harvard.edu. Allan G. Hill, Department of Population and International Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, Telephone: 617-495-3007, E-mail: ahill{at}hsph.harvard.edu.
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