HIV Prevalence In General Population Research Articles

Comparison of programmatic data from antenatal clinics with population-based HIV prevalence estimates in the era of universal test and treat in western Kenya.

To compare HIV prevalence estimates from routine programme data in antenatal care (ANC) clinics in western Kenya with HIV prevalence estimates in a general population sample in the era of universal test and treat (UTT). The study was conducted in the area covered by the Siaya Health Demographic Surveillance System (Siaya HDSS) in western Kenya and used data from ANC clinics and the general population. ANC data (n = 1,724) were collected in 2018 from 13 clinics located within the HDSS. The general population was a random sample of women of reproductive age (15-49) who reside in the Siaya HDSS and participated in an HIV sero-prevalence survey in 2018 (n = 2,019). Total and age-specific HIV prevalence estimates were produced from both datasets and demographic decomposition methods were used to quantify the contribution of the differences in age distributions and age-specific HIV prevalence to the total HIV prevalence estimates. Total HIV prevalence was 18.0% (95% CI 16.3-19.9%) in the ANC population compared with 18.4% (95% CI 16.8-20.2%) in the general population sample. At most ages, HIV prevalence was higher in the ANC population than in the general population. The age distribution of the ANC population was younger than that of the general population, and because HIV prevalence increases with age, this reduced the total HIV prevalence among ANC attendees relative to prevalence standardised to the general population age distribution. In the era of UTT, total HIV prevalence among ANC attendees and the general population were comparable, but age-specific HIV prevalence was higher in the ANC population in most age groups. The expansion of treatment may have led to changes in both the fertility of women living with HIV and their use of ANC services, and our results lend support to the assertion that the relationship between ANC and general population HIV prevalence estimates are highly dynamic.

An international comparison of HIV prevalence and incidence in blood donors and general population: a BEST Collaborative study.

Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different jurisdictions in relation to those rates in the general population and differences in deferral practices. Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody-positive donations and nucleic acid testing (NAT)-only-positive donations was broken down according to first-time or repeat donor status, along with the relevant denominators. There is a modest correlation between HIV prevalence among first-time donors and HIV prevalence in the general population. However, rates of HIV-positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT-only-positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons. Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.

Risk Factors Associated with HIV Infection among General Population in Tanah Papua: Secondary Data Analysis of IBBS in Tanah Papua, Indonesia 2013

HIV prevalence in adult general population in Tanah Papua, has exceeded 1%. Unlike in other regions of the country, that status of the HIV epidemic has entered an early phase of generalized epidemic. The aim of this cross-sectional study as part of National IBBS in Tanah Papua in 2013 was to determine the most important risk factors associated with HIV infection among general population in Tanah Papua in year 2013. The respondents were 5, 334 people aged 15–49 years old who were willing to blood rapid test to determine the HIV status and successfully interviewed. The result showed the HIV prevalence in general population in Tanah Papua was 2.3% (95%CI: 1.5%-3.4%). There were four determinants significantly associated with HIV infection among the general population: topography, ethnicity, access to VCT services, and cost of VCT services. Particularly for males: topography, ethnicity, status of polygamy, circumcision, access to VCT services were also significantly associated with HIV infection.

The changing face of HIV in Latin America and the Caribbean.

Latin America and the Caribbean (LAC) is a region with similarities and important disparities. In recent years LAC has witnessed achievements, with HIV prevalence rates relatively stable for LA and decreasing for the Caribbean. However average values hide differences. General population HIV prevalence in LAC is 0.4 % on average. In the Caribbean there are fewer new HIV infections but HIV prevalence among adults exceeds 1 % in several countries. It is estimated that 31 % of adults living with HIV in LA and 52 % of adults in the Caribbean are women. Unprotected sex is the main route of HIV transmission in LAC. Men who have sex with men and transgender women are the populations with the highest prevalence (10.6 % and 17.7 % respectively); however other key populations such as female sex workers (4.9 %), drug users (range 1 %-49.7 % for intravenous drug users), prisoners and indigenous populations are also important. LAC has the highest anti-retroviral treatment coverage of any low- and middle-income region in the world, but women and children are less likely than men to receive treatment. There is an important pending agenda to address the gaps in information, prevention, and care for HIV in LAC.

HIV transmission from drug injectors to partners who do not inject, and beyond: Modelling the potential for a generalized heterosexual epidemic in St. Petersburg, Russia

BackgroundHIV infection is prevalent among drug injectors in St. Petersburg and their non-injecting heterosexual partners (PIDUs). There are fears that sexual transmission of HIV from IDUs to PIDUs may portend a self-sustaining, heterosexual epidemic in Russia. MethodsOur model combines a network model of sexual partnerships of IDUs and non-IDUs to represent sexual transmission of HIV and a deterministic model for parenteral transmission among IDUs. Behavioural parameters were obtained from a survey of St. Petersburg IDUs and their sexual partners. We based our model fits on two scenarios for PIDU prevalence in 2006 (5.6% and 15.1%, calculated excluding and including HCV co-infected PIDUs respectively) and compared predictions for the general population HIV prevalence. ResultsResults indicate that sexual transmission could sustain a non-IDU HIV epidemic. The model indicates that general population prevalence may be greater than current estimates imply. Parenteral transmission drives the epidemic and the PIDU bridge population plays a crucial role transferring infection to non-IDUs. The model indicates that the high PIDU prevalence is improbable because of the high risk behaviour this implies; the lower prevalence is possible. ConclusionThe model implies that transmission through PIDUs will sustain a heterosexual epidemic, if prevalence among IDUs and PIDUs is as high as survey data suggest. We postulate that current estimates of population prevalence underestimate the extent of the HIV epidemic because they are based on the number of registered cases only. Curtailing transmission among injectors and PIDUs will be vital in controlling heterosexual transmission.

Prevalence of HIV infection and related risk factors in Isfahan Drop in Centers

Background & Objective: HIV infection is considered as an emerging health problem worldwide due to its related health, social, economic, cultural, and political consequences. Though low HIV prevalence in general population in Iran but its prevalence is concentrated among intravenous drug abusers (IDUs). The prevalence of HIV has been increasing in Iran because of parallel epidemics of both HIV infection and injection drug use. In this study the prevalence of HIV and its related risk factors in Isfahan Drop in Centers (DICs) was determined.Methodology: In this cross-sectional study IDUs attended the DICs in Isfahan province were enrolled. Studied population was selected by census sampling method. Venous blood samples were obtained and HIVAb measured using enzyme linked Immunosorbant (ELISA) method. Detailed information regarding demographic characteristics and risk factors of HIV were collected using a structured questionnaire.Result: HIVAb was measured in 539 IDUs. HIVAb test was positive in 6(1.1%) of IDUs. Mean age of HIV positive patients was 35.1 +/- 8.5 y .All of them were male. All HIV positive patients were positive for HCVAb and none was positive for HBsAg, HBsAb and HBcAb. The most common risk factors were travelling overseas, tattooing, and history of imprisonment.Conclusion: The prevalence of HIV infection is low in Iran. However, considering its related risk factors and high rate of HIV-HCV coinfection, it seems that establishing more effective HIV educational programs to decrease behavioral risk factors and scale up harm reduction interventions in IDUs to reduce the burden of HIV and HCV is still necessary.doi: http://dx.doi.org/10.12669/pjms.291(Suppl).3531How to cite this:Javadi AA, Ataei B, Yaran M, Nokhodian Z, Kassaian N, Tayeri K, et al. Prevalence of HIV infection and related risk factors in Isfahan Drop in Centers. Pak J Med Sci 2013;29(1)Suppl:346-350. doi: http://dx.doi.org/10.12669/pjms.291(Suppl).3531 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

High Burden of Prevalent and Recently Acquired HIV among Female Sex Workers and Female HIV Voluntary Testing Center Clients in Kigali, Rwanda

ObjectivesTo estimate HIV prevalence and risk factors in population-based samples of female sex workers (FSW) and female voluntary counseling and testing (VCT) clients in Rwanda.MethodsWe conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included interviewing and testing for HIV-1/2, HSV-2 and pregnancy, and BED-CEIA and Avidity Index (AI) to identify recent infections among HIV-infected women.ResultsPrevalence of HIV-1, HSV-2, and pregnancy were 24% (95% CI: 21.0–27.0), 59.8% (56.4–63.2), and 7.6% (5.8–9.5) among FSW, and 12.8% (10.9–14.6), 43.2% (40.4–46.0), and 11.4% (9.7–13.3) among VCT clients, respectively. Thirty-five percent of FSW and 25% of VCT clients had never been HIV tested. Per national guidelines, 33% of newly HIV-diagnosed FSW and 36% of VCT clients were already eligible for ART based on CD4<350 cells/µl. Condom use at last sex was higher among FSW (74%) than VCT clients (12%). In age and district of residence-adjusted models, HIV-1 seropositivity was associated with HSV-2 co-infection; recent treatment for sexually transmitted infection (STI); genital symptoms; forced sex; imprisonment; widowhood; and alcohol consumption. Eleven percent of FSW and 12% of VCT clients had recently acquired HIV-1 per BED-CEIA and AI. HSV-2 infection and recent STI treatment were associated with recent HIV infection in both groups, and being married and vaginal cleansing were associated with recent infection before last sex among VCT clients.ConclusionsThis population-based survey reveals a high HIV prevalence and incidence among FSW and female VCT clients in Kigali, the scale of which is masked by the low general-population HIV prevalence in Rwanda. HIV/STI and family planning services should be strengthened.

O1-S11.02 Determinants of time trends in HIV prevalence in the young antenatal population of Karnataka districts

BackgroundIn 2003, the Bill & Melinda Gates Foundation initiated a focused HIV prevention program (India AIDS Initiative: Avahan) among high-risk and bridge groups. We studied determinants of time trends in...

To what extent is the HIV epidemic in southern India driven by commercial sex? A modelling analysis

In south India, general population HIV prevalence estimates range from 0.5 to 3%. To focus HIV prevention efforts, it is important to understand whether HIV transmission is driven by commercial sex. A dynamic HIV/sexually transmitted infection transmission model was parameterized using data from Belgaum and Mysore in south India. Fits to sexually transmitted infection/HIV data from female sex workers (FSWs) and their clients for each district were obtained. Model HIV/herpes simplex virus-2 (HSV-2) prevalence projections for the general population were cross-validated against empirical estimates not used to fit model. The model estimated the proportion of incident HIV/HSV-2 infections due to HIV/HSV-2 transmission between FSWs/clients, their noncommercial partners and other low-risk partnerships. The relative impact of a generic intervention targeting different partnerships was explored. The model's general population HIV/HSV-2 prevalence projections agreed well with empirical estimates. Recent increases in condom use resulted in decreasing HIV epidemics in both settings. For men, most incident HIV/HSV-2 infections (>90%) directly result from commercial sex, whereas for women most are due to bridging infections from clients of FSWs (80-90%) with the remainder mainly due to commercial sex. Less than 1.5% of incident infections are due to low-risk partnerships. Intervention impact is maximized through targeting commercial sex but substantial impact could also be achieved through targeting noncommercial partners of clients. In southern India, HIV transmission could be driven by FSWs and their clients. While efforts to reduce HIV transmission due to commercial sex must continue, prevention programmes should also consider strategies to prevent transmission from clients to their noncommercial partners.

Variability in the sexual structure in a rural Indian setting: implications for HIV prevention strategies

To describe the sexual structure, including numbers and distribution of female sex workers (FSWs) and male sexual behaviours in the Bagalkot district of the state of Karnataka in south India. Village health workers and peer educators enumerated FSWs in each village by interviewing key informants and FSWs. Urban FSW populations were estimated using systematic interviews with key informants to identify sex work sites and then validating FSW populations at each sex work site. Male sexual behaviours were measured through confidential polling booth surveys in randomly selected villages. HIV prevalence was estimated through a community-based survey using randomised cluster sampling. Lorenz curves and Gini coefficients were used to describe the degree of clustering of FSW populations. Of an estimated 7280 FSWs in Bagalkot district (17.1/1000 adult males), 87% live and work in rural areas. The relative size of the FSW population varies from 9.6 to 30.5/1000 adult males in the six subdistrict administrative areas (talukas). The FSW population was highest in the three talukas with more irrigated land and fewer and larger villages. FSW populations are highly clustered; 93 (15%) of the villages accounted for 54% of all rural FSWs. There is a high degree of FSW clustering in all talukas, and talukas with fewer and larger villages have larger clusters and more FSWs overall. General population HIV prevalence is highest in the taluka with the highest relative FSW population. Prevention programmes in India should be scaled up to reach FSWs in rural areas. These programmes should be focused on those districts and subdistrict areas with large concentrations of FSWs. More research is required to determine the distribution of FSWs in rural areas in other regions of India.