Preponderance of females with AIDs in Ghana [letter]

In February 1986 a survey on 98 Ghanaian prostitutes in the Accra area including the port of Tema uncovered only 1 who was positive for antibody to human immunodeficiency virus (HIV) and none had lymphadenopathy. 76 had lived in Accra/Tema for 5 years or more. Most of them practiced vaginal intercourse only and most did not use condoms (as seen in table 1). Of the non-Ghanaian sexual partners those most frequently mentioned were Koreans and Japanese (by 19 out of 43 patients). West Africans (16) and Europeans (9). A survey of 247 Ghanaian blood donors done at the same time found none seropositive for HIV. Up to March 1986 no clinical case of AIDS had been seen in Accra. However from March to September 1986 an increasing number of seropositive Ghanaians have been seen (as seen in table 2). 2 presented in March and 21 in September. 44 had AIDS or AIDS-related complex. 1 patient with AIDS was 3-month-old baby delivered of a woman with AIDS. Both have died. Strikingly 63 of the 72 seropositives have been female. Most came home from neighboring African countries because they were ill some dying soon after arrival. 55 have returned from Abidjan (Ivory Coast) 2 from Burkina Faso 1 from Senegal and 2 from West Germany. In recent years economic hardships have forced many young Ghanaians to go abroad to work as prostitutes especially in Ivory Coast. Many of the patients admitted to prostitution as their means of support. It seems that local prostitutes and residents in Accra are as yet largely uninfected with HIV but that there may now be an influx of infected people. The numbers of sexual contacts with Japanese and Koreans may be a pointer to how infection can spread to other areas of the world. (full text)