Abstract

The main objective of Benin's national AIDS control program is the prevention of HIV infection transmission through the development of information, education, and communication activities. This project will provide a better knowledge of the risk factors of AIDS transmission. The mechanism of HIV1 and HIV2 virus transmission being well known, the project will compare 100 seropositive patients to 300 seronegative controls to test the hypothesis that the risk factors and cofactors found in patients are not extant in the controls. A further hypothesis to be tested is that the factor/cofactor distribution is the same for the more virulent HIV1 as for the weaker HIV1 virus. The researchers will be MDs who obtained their degrees with theses on AIDS. The project will build and strengthen Benin's research capacity.

Post-Project Summary

The case-control study was carried out in Bénin from September to December 1989. There were 77 cases and 231 controls, in six provinces. Subjects were questioned about the preceding 5 years with respect to history of sexually transmitted disease (STD), sexual and cultural practices, and the number of transfusions received. The number of sexual partners was requested for three different dates: the time of the survey, 2 years before and 5 years before. Information was also requested on subjects' knowledge of HIV transmission prevention, and their sociodemographic characteristics. All the researchers were physicians, and most had written their doctoral thesis on AIDS.

Age was strongly associated with HIV infection. The average was 30.5 years for cases and 26.7 for controls. However, the 30.5 average for cases varied according to sex: 31.5 for males and 26.7 for females.

The number of sexual partners known 5 years before was a risk factor strongly associated with HIV infection: the average number of known sexual partners 5 years before the survey was 5.2 for cases and 1.8 for controls. Among male subjects, frequenting prostitutes was mentioned by 50% of cases and 27% of controls. Having a seropositive sexual partner proved to be a significant risk factor. A history of STD was among the factors favouring HIV (co-factors). Receiving a transfusion was associated with being seropositive by a factor of 3.3, while receiving injections with single-use needles and syringes was encountered in the same proportions among cases and controls. Condom use (always, often, sometimes) was mentioned in the same proportions by cases and controls.

The results of the study indicate that HIV infection in Bénin is due essentially to HIV-1 (73 cases out of 75), in most cases by heterosexual transmission. The infection risk factors are the usual ones. The post-transfusion AIDS risk, eliminated in 1985 in the developed countries, is still present in Bénin. The effect of cultural practices (tattooing, scarification, circumcision and so on) was not demonstrated in this study, but merits further investigation. Given that seropositive subjects were less knowledgeable about AIDS than seronegative subjects, this group in particular - and the population in general - should be addressed through an effective information campaign in order to limit the spread of this epidemic.

Recipient Institution(s)