Sera of all male donors appearing at the blood bank of a regional hospital in Northwest Ethiopia in 1994 (n = 1022) and 1995 (n = 1164), were screened for the presence of human immunodeficiency virus (HIV-1) and treponemal antibodies. Additionally, screening for hepatitis B surface antigen (HBsAg) was carried out on 549 consecutive sera. In 1995, the crude seroprevalence of HIV-1 infection and syphilis was 16.7% and 12.8%. Seroprevalence of HBsAg was 14.4%. HIV and syphilis seroprevalence was highest in soldiers (30.6% and 20.9%) and daily workers (18.8% and 13.5%), and lowest in farmers (8% and 6.7%). However, farmers had the highest rate of HBsAg (18.8%). HIV-positive donors had an increased risk for being positive for syphilis antibodies (OR = 3.69, 95% CI = 2.69-4.96), but not for HBsAg (OR = 0.79, 95% CI = 0.36-1.67). The data indicate that (i) the HIV epidemic has not yet reached a plateau phase in Ethiopia, and (ii) the transmission and epidemiology of HBsAg in Ethiopia is different from that of HIV and syphilis.

The prevalence of sexually transmitted diseases (STD) among women visiting antenatal (ANC) and gynaecological clinics in Gondar, north-west Ethiopia, was investigated. Between April and August 1995, 728 women consented to enter the study. Prevalence rates were 5.9% (41/693) for chlamydial antigen in cervix, 18.8% (113/600) for syphilis (Treponema pallidum haemagglutination assay [TPHA]) and 25.3% (150/593) for HIV. Active syphilis (RPR)+, TPHA+ was detected in 74% (44/597). HIV infection rate was higher among women with higher age of first marriage and low gravidity. It was significantly associated with young age, urban residence, and presence of genital ulcer (odds ratio [OR] = 6.3), and lymphadenopathy (OR = 2.8) on examination. Women seropositive for syphilis had married at an earlier age, were significantly older and had changed husbands. Low gravidity and age < 30 were independently significant risk factors for cervical chlamydial antigen positivity which was predominantly asymptomatic. Significant association was observed between HIV infection and syphilis (OR = 2.6). Active syphilis was associated with chlamydial (OR = 3.4) and HIV infection (OR = 4.1). The rate of 23.4% and 15.1% of HIV seropositivity among ANC attenders and rural women respectively is an indicator of the rapid progression of the HIV epidemic in the area.

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