Practising obstetrics and gynaecology in areas with a high prevalence of HIV infection

Practising obstetrics and gynaecology in areas with a high prevalence of HIV infection

What is it like to practise obstetrics and gynaecology in a country with a high prevalence of HIV infection? My experience relates especially to Zimbabwe, but the same factors apply equally well to Zambia, Zaire, Uganda, Kenya, Tanzania, Malawi, and Mozambique. Within a population of 11 million in Z...

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Bibliographic Details
Published in:The Lancet (British edition) Vol. 346; no. 8970; p. 293
Main Author: Verkuyl, D A
Format: Journal Article
Language:English
Published: England 29-07-1995
Subjects:
Adolescent
Adult
Contact Tracing
Contraception
Family Planning Services
Female
Gynecology
HIV Antibodies - blood
HIV Infections - prevention & control
HIV Infections - transmission
HIV Seroprevalence
HIV-1
Humans
Obstetrics
Zimbabwe - epidemiology
Zimbabwe
Eastern Africa
Health Services
Health
Gynecology
Africa
Viral Diseases
Contraception
Hiv Infections
Delivery Of Health Care
Family Planning
English Speaking Africa
Obstetrics
Diseases
Pregnancy Outcomes
Medicine
Pregnancy
Reproduction
Acquired Immunodeficiency Syndrome
Fetus
Zimbabwe
Developing Countries
Africa South Of The Sahara
Delivery
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Summary:What is it like to practise obstetrics and gynaecology in a country with a high prevalence of HIV infection? My experience relates especially to Zimbabwe, but the same factors apply equally well to Zambia, Zaire, Uganda, Kenya, Tanzania, Malawi, and Mozambique. Within a population of 11 million in Zimbabwe, at least 1 million are HIV positive according to the official figures. AIDS often means "home-based care"; the nearest clinic or hospital, which has very little to offer, may be 3 hours away by wheelbarrow. Many patients who die with chronic diarrhoea lack a piped water supply nearby, an indoor toilet, or even a waterproof sheet. Every year in Zimbabwe there are 120,000 confinements of HIV-positive women compared with 7000 HIV-positive pregnancies in the USA. Transmission of the virus in Africa is mainly heterosexual and vertical, although blood transfusion still plays a part. Intravenous drug use is not a problem but alcohol is, by way of promoting risky behaviour. A secondary epidemic of tuberculosis (TB) (also among HIV-negative persons) adds to the difficulties in sub-Saharan Africa.
ISSN:0140-6736
DOI:10.1016/S0140-6736(95)92171-0