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.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: HIV prevalence data from prevention of mother-to-child-transmission (PMTCT) programs are being utilized to monitor the trend of HIV epidemics that helps policy makers to take appropriate action. To determine the trend of HIV among pregnant women attending the antenatal care unit of Bishoftu Hospital from January 2006 to June 2010. A cross-sectional study was conducted to determine the prevalence of HIV among pregnant women attending the ANC unit of Bishoftu Hospital. Data were analyzed for descriptive statistics and Chi-square for trends using SPSS Version 15.0. P-values < or = 0.05 were considered significant. A total of 7887 pregnant women were registered in the ANC unit of Bishoftu Hospital from January 2006 to June 2010. The overall HIV prevalence rate was 5.4%. High prevalence rates were observed in those aged between 25-45 years. There was a decline in HIV prevalence from 8.3% in 2006 to 4.3% in 2010. A total of 1247 pregnant women were tested together with their partner. Of these, in 3.1% of the cases, both partners tested positive and 4.9% were discordant couples where 2.4% were female positive and male negative while 2.5% were male positive and female negative. A remarkable decline in HIV prevalence was observed during the five years period The study also revealed that relatively higher proportions of HIV infected persons are living in a serodiscordant partnership. The involvement of male partners in HIV counseling and testing and preventive interventions targeted at HIV-negative individuals with discordant partnerships are urgently needed.
    Ethiopian medical journal 07/2013; 51(3):169-76.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cervical cancer kills more women in low-income nations than any other malignancy. A variety of research and demonstration efforts have proven the efficacy and effectiveness of low-cost cervical cancer prevention methods but none in routine program implementation settings of the developing world, particularly in HIV-infected women. In our public sector cervical cancer prevention program in Zambia, nurses conduct screening using visual inspection with acetic acid aided by digital cervicography. Women with visible lesions are offered same-visit cryotherapy or referred for histologic evaluation and clinical management. We analyzed clinical outcomes and modeled program effectiveness among HIV-infected women by estimating the total number of cervical cancer deaths prevented through screening and treatment. Between 2006 and 2008, 6572 HIV-infected women were screened, 53.6% (3523) had visible lesions, 58.5% (2062) were eligible for cryotherapy and 41.5% (1461) were referred for histologic evaluation. A total of 75% (1095 out of 1462) of patients who were referred for evaluation complied. Pathology results from 65% (715 out of 1095) of women revealed benign abnormalities in 21% (151), cervical intraepithelial neoplasia (CIN) I in 30% (214), CIN 2/3 in 33% (235) and invasive cervical cancer in 16.1% (115, of which 69% were early stage). Using a conditional probability model, we estimated that our program prevented 142 cervical cancer deaths (high/low range: 238-96) among the 6572 HIV-infected women screened, or one cervical cancer death prevented per 46 (corresponding range: 28-68) HIV-infected women screened. Our prevention efforts using setting-appropriate human resources and technology have reduced morbidity and mortality from cervical cancer among HIV-infected women in Zambia. Financial support for implementing cervical cancer prevention programs integrated within HIV/AIDS care programs is warranted. Our prevention model can serve as the implementation platform for future low-cost HPV-based screening methods, and our results may provide the basis for comparison of programmatic effectiveness of future prevention efforts.
    HIV therapy. 01/2010; 4(6):703-722.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Residents of Zambézia Province, Mozambique live from rural subsistence farming and fishing. The 2009 provincial HIV prevalence for adults 15-49 years was 12.6%, higher among women (15.3%) than men (8.9%). We reviewed clinical data to assess outcomes for HIV-infected children on combination antiretroviral therapy (cART) in a highly resource-limited setting.
    PLoS ONE 10/2014; 9(10):e110116. · 3.53 Impact Factor

Full-text (2 Sources)

Available from
May 23, 2014