Declining HIV prevalence among young pregnant women in Lusaka, Zambia

Department of Obstetrics and Gynecology, University of Alabama, Birmingham, AL, United States of America.
Bulletin of the World Health Organisation (Impact Factor: 5.11). 10/2008; 86(9):697-702. DOI: 10.2471/BLT.07.045260
Source: PubMed

ABSTRACT HIV prevention has been ongoing in Lusaka for many years. Recent reports suggest a possible decline in HIV sero-incidence in Zambia and some neighbouring countries. This study aimed to examine trends in HIV seroprevalence among pregnant and parturient women between 2002 and 2006.
We analysed HIV seroprevalence trends from two Lusaka sources: (i) antenatal data from a city-wide programme to prevent mother-to-child HIV transmission, and (ii) delivery data from two anonymous unlinked cord-blood surveillances performed in 2003 and again in 2005-2006, where specimens from > 97% of public-sector births in each period were obtained and analysed.
Between July 2002 and December 2006, the Lusaka district tested 243 302 antenatal women for HIV; 54 853 (22.5%) were HIV infected. Over this period, the HIV seroprevalence among antenatal attendees who were tested declined steadily from 24.5% in the third quarter of 2002 to 21.4% in the last quarter of 2006 (P < 0.001). The cord-blood surveillances were conducted between June and August 2003 and again between October 2005 and January 2006. Overall HIV seroprevalence declined from 25.7% in 2003 to 21.8% in 2005-2006 (P = 0.001). Among women < or =17 years of age, seroprevalence declined from 12.1% to 7.7% (P = 0.015).
HIV seroprevalence appears to be declining among antenatal and parturient women in Lusaka. The decline is most dramatic among women < or = 17 years of age, suggesting a reduction in sero-incidence in this important age group.

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Available from: Moses Sinkala, Aug 26, 2015
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    • "These mHIV-EU infants are the majority of children affected by maternal exposure to HIV-1. Where antenatal HIV-1 infection is between 20 and 25% as in Zambia, mHIV-EU infants are a large proportion of all births [24] [25]. "
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    • "Clinical data from the same time period indicate that 82 percent of ANC attendees in Lusaka were offered a HIV test, 71 percent of these accepted the test offer, and 99 percent of those tested received the result (Stringer et al 2005). Since mid-2005, over 90 percent of ANC attendees at Lusaka city ANCs have been tested for HIV (Stringer et al 2008b). In Zambia as a whole, administrative data indicate that 65 percent of pregnant women in 2007 took a HIV test during an ANC visit (UNAIDS Annex 3). "
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    • "Lusaka is home to almost 2 million people [14]. The HIV prevalence rate among pregnant women is 21% [15], and the majority of women infected with HIV are of reproductive age. The Ministry of Health's ART program was established in 2004 and covers the entire city. "
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