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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Declining HIV prevalence and risk behaviours in Zambia: Evidence from surveillance and population-based surveys
AIDS, Volume 15, No. 7, Year 2001
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Description
Objective: To examine trends in HIV prevalence and behaviours in Zambia during the 1990s. Methods: The core Zambian system for epidemiological surveillance and research has two major components: (i) HIV sentinel surveillance at selected antenatal clinics (ANC) in all provinces; and (ii) population-based HIV surveys in selected sentinel populations (1996 and 1999). The former was refined in 1994 to improve the monitoring of prevalence trends, whereas the latter was designed to validate ANC-based data, to study change in prevalence and behaviour concomitantly and to assess demographic impacts. Results: The ANC-based data showed a dominant trend of significant declines in HIV prevalence in the 15-19 years age-group, and for urban sites also in age-group 20-24 years and overall when rates were adjusted for over-representation of women with low education. In the general population prevalence declined significantly in urban women aged 15-29 years whereas it showed a tendency to decline among rural women aged 15-24 years. Prominent decline in prevalence was associated with higher education, stable or rising prevalence with low education. There was evidence in urban populations of increased condom use, decline in multiple sexual partners and, among younger women, delayed age at first birth. Conclusions: The results suggested a dominant declining trend in HIV prevalence that corresponds to declines in incidence since the early 1990s attributable to behavioural changes. Efforts to sustain the ongoing process of change in the well-educated segments of the population should not be undervalued, but the modest change in behaviour identified among the most deprived groups represents the major preventive challenge. © 2001 Lippincott Williams & Wilkins.
Authors & Co-Authors
Fýlkesnes, Knut M.
Norway, Tromso
Uit Norges Arktiske Universitet
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Zambia, Lusaka
National tb and Leprosy Control Program
Zambia, Lusaka
University Teaching Hospital Lusaka
Musonda, Rosemary Mubanga
Norway, Tromso
Uit Norges Arktiske Universitet
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Zambia, Lusaka
National tb and Leprosy Control Program
Zambia, Lusaka
University Teaching Hospital Lusaka
Sichone, Moses
Norway, Tromso
Uit Norges Arktiske Universitet
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Zambia, Lusaka
National tb and Leprosy Control Program
Zambia, Lusaka
University Teaching Hospital Lusaka
Ndhlovu, Zacchaeus
Norway, Tromso
Uit Norges Arktiske Universitet
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Zambia, Lusaka
National tb and Leprosy Control Program
Zambia, Lusaka
University Teaching Hospital Lusaka
Tembo, Francis
Norway, Tromso
Uit Norges Arktiske Universitet
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Zambia, Lusaka
National tb and Leprosy Control Program
Zambia, Lusaka
University Teaching Hospital Lusaka
Monze, Mwaka
Norway, Tromso
Uit Norges Arktiske Universitet
Zambia, Ndola
Tropical Diseases Research Centre Ndola
Zambia, Lusaka
National tb and Leprosy Control Program
Zambia, Lusaka
University Teaching Hospital Lusaka
Statistics
Citations: 263
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1097/00002030-200105040-00011
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Zambia
Participants Gender
Female