Recent HIV prevalence trends among pregnant women and all women in sub-Saharan Africa: implications for HIV estimates
SOURCE: AIDS
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2014
TITLE AUTHOR(S): J.W.Eaton, T.M.Rehle, S.Jooste, R.Nkambule, A.A.Kim, M.Mahy, T.B.Hallett
KEYWORDS: ANTENATAL CARE, FERTILITY, HIV/AIDS, HOUSEHOLDS, PREGNANCY, SUB-SAHARAN AFRICA, WOMEN
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8433
HANDLE: 20.500.11910/2180
URI: http://hdl.handle.net/20.500.11910/2180
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2014
TITLE AUTHOR(S): J.W.Eaton, T.M.Rehle, S.Jooste, R.Nkambule, A.A.Kim, M.Mahy, T.B.Hallett
KEYWORDS: ANTENATAL CARE, FERTILITY, HIV/AIDS, HOUSEHOLDS, PREGNANCY, SUB-SAHARAN AFRICA, WOMEN
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8433
HANDLE: 20.500.11910/2180
URI: http://hdl.handle.net/20.500.11910/2180
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
National population-wide HIV prevalence and incidence trends in sub-Saharan Africa (SSA) are indirectly estimated using HIV prevalence measured among pregnant women attending antenatal clinics (ANC), among other data. We evaluated whether recent HIV prevalence trends among pregnant women are representative of general population trends. Serial population-based household surveys in 13 SSA countries. We calculated HIV prevalence trends among all women aged 15-49 years and currently pregnant women between surveys conducted from 2003 to 2008 (period 1) and 2009 to 2012 (period 2). Log-binomial regression was used to test for a difference in prevalence trend between the two groups. Prevalence among pregnant women was age-standardized to represent the age distribution of all women. Pooling data for all countries, HIV prevalence declined among pregnant women from 6.5 [95% confidence interval (CI) 5.3-7.9%] to 5.3% between periods 1 and 2, whereas it remained unchanged among all women at 8.4% (95% CI 8.0-8.9%) in period 1 and 8.3% (95% CI 7.9-8.8%) in period 2. Prevalence declined by 18% more in pregnant women than nonpregnant women. Estimates were similar in Western, Eastern, and Southern regions of SSA; none were statistically significant (P>0.05). HIV prevalence decreased significantly among women aged 15-24 years while increasing significantly among women 35-49 years, who represented 29% of women but only 15% of pregnant women. Age-standardization of prevalence in pregnant women did not reconcile the discrepant trends because at older ages prevalence was lower among pregnant women than nonpregnant women. As HIV prevalence in SSA has shifted toward older, less-fertile women, HIV prevalence among pregnant women has declined more rapidly than prevalence in women overall. Interpretation of ANC prevalence data to inform national HIV estimates should account for both age-specific fertility patterns and HIV-related sub-fertility.-
Related Research Outputs:
- Factors influencing pregnancy desires among HIV positive women in Gert Sibande district in Mpumalanga, South Africa
- Psychological distress and associated factors among a sample of pregnant women in South Africa
- Fertility intentions of prenatal and postpartum HIV-positive women in primary care in Mpumalanga province, South Africa: a longitudinal study
- Depression among pregnant rural South African women undergoing HIV testing
- Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV
- Alcohol consumption among HIV-positive pregnant women in KwaZulu-Natal, South Africa: prevalence and correlates
- HIV knowledge and sexual risk behavior among pregnant couples in South Africa: the PartnerPlus project
- Sexual HIV risk behaviour and associated factors among pregnant women in Mpumalanga, South Africa
- A cluster randomized controlled trial evaluating the efficacy of peer mentors to support South African women living with HIV and their infants
- Pregnant women living with HIV (WLH) supported at clinics by peer WLH: a cluster randomized controlled trial
- Collecting maternal health information from HIV-positive pregnant women using mobile phone-assisted face-to-face interviews in southern Africa
- HIV knowledge, disclosure and sexual risk among pregnant women and their partners in rural South Africa
- Barriers to recruitment and retention of pregnant HIV-positive black South African women into PMTCT intervention programs: a loss to follow-up
- Letter to the editor: response to
- Prevalence of prenatal depression and associated factors among HIV-positive women in primary care in Mpumalanga province, South Africa
- Intimate partner violence among HIV positive pregnant women in South Africa
- Prevalence and psychosocial correlates of suicidal ideation among pregnant women living with HIV in Mpumalanga province, South Africa
- Determinants of HIV infection among adolescent girls and young women aged 15-24 years in South Africa: a 2012 population-based national household survey
- Acceptability of women-delivered HIV self-testing to the male partner, and additional interventions: a qualitative study of antenatal care participants in Malawi
- Factors associated with male partner involvement in programs for the prevention of mother-to-child transmission of HIV in rural South Africa