Sociocultural and epidemiological aspects of HIV/AIDS in Mozambique

Carolyn M Audet,Troy D Moon,Mohsin Sidat,Janeen Burlison,Sten H Vermund,Alfredo E Vergara

doi:10.1186/1472-698x-10-15

Abstract

BackgroundA legacy of colonial rule coupled with a devastating 16-year civil war through 1992 left Mozambique economically impoverished just as the human immunodeficiency virus (HIV) epidemic swept over southern Africa in the late 1980s. The crumbling Mozambican health care system was wholly inadequate to support the need for new chronic disease services for people with the acquired immunodeficiency syndrome (AIDS).MethodsTo review the unique challenges faced by Mozambique as they have attempted to stem the HIV epidemic, we undertook a systematic literature review through multiple search engines (PubMed, Google Scholar™, SSRN, AnthropologyPlus, AnthroSource) using Mozambique as a required keyword. We searched for any articles that included the required keyword as well as the terms 'HIV' and/or 'AIDS', 'prevalence', 'behaviors', 'knowledge', 'attitudes', 'perceptions', 'prevention', 'gender', drugs, alcohol, and/or 'health care infrastructure'.ResultsUNAIDS 2008 prevalence estimates ranked Mozambique as the 8th most HIV-afflicted nation globally. In 2007, measured HIV prevalence in 36 antenatal clinic sites ranged from 3% to 35%; the national estimate of was 16%. Evidence suggests that the Mozambican HIV epidemic is characterized by a preponderance of heterosexual infections, among the world's most severe health worker shortages, relatively poor knowledge of HIV/AIDS in the general population, and lagging access to HIV preventive and therapeutic services compared to counterpart nations in southern Africa. Poor education systems, high levels of poverty and gender inequality further exacerbate HIV incidence.ConclusionsRecommendations to reduce HIV incidence and AIDS mortality rates in Mozambique include: health system strengthening, rural outreach to increase testing and linkage to care, education about risk reduction and drug adherence, and partnerships with traditional healers and midwives to effect a lessening of stigma.

Highlights

A legacy of colonial rule coupled with a devastating 16-year civil war through 1992 left Mozambique economically impoverished just as the human immunodeficiency virus (HIV) epidemic swept over southern Africa in the late 1980s
In 2007, HIV prevalence in the 36 antenatal clinic (ANC) sentinel surveillance sites ranged from 3% to 35% with a national estimate of 16% in women ages 15-49 years [1]
Unpublished reports were requested from the Centers for Disease Control and Prevention (CDC) in Mozambique, the Joint United Nations Programme on HIV/acquired immunodeficiency syndrome (AIDS) (UNAIDS), the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), and the Mozambique Ministry of Health (MISAU)

Summary

Introduction

A legacy of colonial rule coupled with a devastating 16-year civil war through 1992 left Mozambique economically impoverished just as the human immunodeficiency virus (HIV) epidemic swept over southern Africa in the late 1980s. Mozambique, a southeast African nation of ≈21 million people, suffers one of the world's highest burdens of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) (Figure 1). In 2007, HIV prevalence in the 36 antenatal clinic (ANC) sentinel surveillance sites ranged from 3% to 35% with a national estimate of 16% (plausibility bounds from 14-17%) in women ages 15-49 years [1]. Provincial HIV prevalence estimates ranged from 8% to 27% and were highest in the central and southern provinces [1]. By 2001, one million people were estimated to be living with HIV, including 53,000 children under the age of 18 and 570,000 women [1]. Prior to 2004, ART was available only through pilot programs, with the majority of the popula-

Methods

Results

Discussion

Conclusion