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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal, South Africa
International Journal of Epidemiology, Volume 40, No. 4, Article dyq176, Year 2011
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Description
Background: In mature generalized human immunodeficiency virus (HIV) epidemics, as survival from accessing antiretroviral treatment (ART) increases, HIV prevalence data may be suboptimal and difficult to interpret without HIV incidence rates. Objective: To determine the HIV incidence rate among rural and urban women in KwaZulu-Natal, South Africa. Methods: We conducted a prospective cohort study fromMarch 2004 toMay 2007. Volunteers were recruited from a rural family-planning clinic and an urban clinic for sexually transmitted infections. Consenting, HIVuninfected women aged 14-30 years were enrolled. Demographic, clinical, sexual and behavioural data were collected using standardized questionnaires with HIV risk reduction counselling and HIV testing. Pelvic examinations were completed at quarterly visits. Results: The HIV prevalence at screening was 35.7% [95% confidence interval (CI) 32.7-38.8] amongst rural women and 59.3% (95% CI 56.5-62.0) amongst urban women. A total of 594/2240 (26.5%) enrolled women contributed to 602 person-years (PYs) of follow-up. The median age was 22 years [inter-quartile range 18-23 years]. HIV incidence rate was 6.5/100 PY (95% CI 4.4-9.2) amongst rural women and 6.4/100 PY (95% CI 2.6-13.2) amongst urban women. HIV incidence rate of 17.2/100 PY (95% CI 2.1-62.2) was highest amongst urban women <20 years of age and 10.2/100 PY (95% CI 4.1-20.9) amongst rural women ≥25 years of age. Conclusion: HIV incidence rates are devastatingly high in young women in rural and urban KwaZulu-Natal, despite reports of stabilized HIV prevalence observed in current surveillance data. The diffuse nature of the HIV epidemic underscores the urgent need to enhance HIV prevention and treatment modalities. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.
Authors & Co-Authors
Abdool Karim, Quarraisha Abdool
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
United States, New York
Mailman School of Public Health
Kharsany, Ayesha B.M.
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Fröhlich, Janet A.
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Mashego, M. M.
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Mlotshwa, Mukelisiwe
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Madlala, Bernadette T.
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Ntombela, Fanelisibonge
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Abdool Karim, Salim S.
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
United States, New York
Mailman School of Public Health
Statistics
Citations: 126
Authors: 8
Affiliations: 2
Identifiers
Doi:
10.1093/ije/dyq176
ISSN:
03005771
e-ISSN:
14643685
Research Areas
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female