HIV antibodies in a remote rural area in Rwanda, Central Africa: an analysis of potential risk factors for HIV seropositivity.

Detection of HIV antibodies by means of an immunoenzymatic assay, an indirect immunofluorescence technique and Western blot was attempted on 375 serum samples collected in the Murunda area, a remote rural area situated in Rwanda, central Africa. Two out of 147 (1.4%) adults from a strict rural area, five out of 59 (8.5%) adults from an adjacent market place, and 49 out of 169 (30%) STD clinic attenders from the same area were HIV seropositive. In the first two groups, HIV seropositivity was associated with a history of sexually transmitted disease (STD) in the previous 2 years (P less than 0.001) and with a history of travel to a Rwandese urban centre in the previous 5 years (P less than 0.05). This study suggests that HIV seroprevalence is low in rural central Africa compared with urban centres. Risk factors for HIV seropositivity are similar in rural and urban-based adults in Rwanda, i.e. heterosexual promiscuity and STDs. Many HIV seropositive rural subjects from this study are likely to have acquired HIV infection through sexual contacts in Rwandese cities.