High HIV-1 incidence in young women masked by stable overall seroprevalence among childbearing women in Kinshasa, Zaïre

Batter, V.; Matela, B.; Nsuami, Malanda; Manzila, T.; Kamenga, Munkolenkole; Behets, Frieda; Ryder, R.W.; Heyward, William L.; Karon, J. M.; Louis, Michael E. St.

doi:10.1097/00002030-199406000-00014

Cited by 81 publications

(31 citation statements)

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“…Several sophisticated formulations of this approach have been published and include adjustments for mortality [5][6][7]. These approaches are suitable for younger study populations but have limited utility for studies of older individuals.…”

Section: Discussionmentioning

confidence: 99%

Estimating HIV hazard rates from cross-sectional HIV prevalence data

2006

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We propose a method of estimating the HIV hazard rate in a population when only cross-sectional data measuring HIV-prevalence are available. In a cross-sectional study, individuals who test positive are left-censored since we know only that the transition time is smaller than the monitoring time. Individuals who test negative are right-censored since we know only that the transition time is greater than the monitoring time. The transition time is not observed directly. For our method, we assume the hazard rate is well-defined after the time we start screening. We assume further the mortality rates for HIV-positive and HIV-negative individuals are known. The method is illustrated using HIV-prevalence data collected over four years among women in Cape Town, South Africa.

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Section: Discussionmentioning

confidence: 99%

Estimating HIV hazard rates from cross-sectional HIV prevalence data

2006

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“…Turning to the evidence, many African studies, both clinic and cohort based, indicate that total fertility or childbearing odds are lower among HIV positive women (Allen et al, 1993;Batter et al, 1994;Ryder et al, 1991;Carpenter et al, 1997;Sewankambo et al, 1994;Hunter et al 2003;Zambuko and Mturi 2005). The relative importance of physiological factors, on the one hand, and behavioral responses to being HIV positive, on the other, in explaining these differences are not clear.…”

Section: Ii42 Responses Of Fertility To Hiv/aidsmentioning

confidence: 99%

Reproductive Health and Behavior, HIV/AIDS, and Poverty in Africa

Glick

2007

SSRN Journal

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This paper examines the complex linkages of poverty, reproductive/sexual health and behavior, and HIV/AIDS in Africa. It addresses the following questions:(1) what have we learned to date about these links and what are the gaps in knowledge to be addressed by further research; (2) what is known about the effectiveness for HIV prevention of reproductive health and HIV/AIDS interventions and policies in Africa; and (3) what are the appropriate methodological approaches to research on these questions. With regard to what has been learned so far, the paper pays considerable attention in particular to the evidence regarding the impacts of a range of HIV interventions on risk behaviors and HIV incidence. Other sections review the extensive microeconomic literature on the impacts of AIDS on households and children in Africa and the effects of the epidemic on sexual risk behavior and fertility decisions. With regard to methodology, the paper assesses the approaches used in the literature to deal with, among other things, the problem of self-selection and nonrandomness in the placement of HIV and reproductive health programs. Data requirements for different research questions are discussed, and an effort is made to assess what researchers can learn from existing sources such as Demographic and Health Surveys.3

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“…Between 1986 and 1989, HIV prevalence among pregnant women in urban areas ranged from 5.8% to 6.5%. 13,14 Since then, HIV prevalence among women attending antenatal care in Kinshasa has fluctuated, from 5.7% in 1987 to 10.8% in 1992, 5.4% in 1999, and 3.0% in 2002. 15 In 2004, the HIV prevalence in the DRC population was estimated to be 4.2%.…”

Section: Preventing Vertical Transmission Of Hiv Inmentioning

confidence: 99%

Preventing vertical transmission of HIV in Kinshasa, Democratic Republic of the Congo: a baseline survey of 18 antenatal clinics

Behets

Matendo

Vaz³

et al. 2006

Bull World Health Organ

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Objective To assess the content and delivery of essential antenatal services before implementation of programmes for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). Methods We assessed 18 antenatal care centres (eight public units and ten managed by nongovernmental organizations) in Kinshasa, Democratic Republic of the Congo. We used a survey to capture information about the number and type of antenatal health workers, infrastructure capacity and the delivery of basic antenatal care services such as: nutritional counselling; tetanus toxoid vaccination; prevention and management of anaemia, malaria, sexually transmitted infections, and tuberculosis; and counselling for postpartum contraception. Findings Antenatal care units differed with respect to size, capacity, cost, service delivery systems and content. For instance, 17 of the 18 sites offered anaemia screening but only two sites included the cost in the card that gives access to antenatal care. Nine of the clinics (50%) reported providing the malaria prophyalxis sulfadoxine pyrimethamine as per national policy. Four (22%) of the sites offered syphilis screening. Conclusion Scaling up PMTCT programmes in under-resourced settings requires evaluation and strengthening of existing basic antenatal care service delivery. IntroductionAt the end of 2005, an estimated 38.6 million people were living with human immunodeficiency virus (HIV). Nearly two-thirds of these were in sub-Saharan Africa 1,2 where countries struggling to respond to the crisis are simultaneously battling poverty, poor infrastructure, competing health needs and, in some cases, civil unrest. In 2004, women represented 57% of all cases of HIV in sub-Saharan Africa and made up nearly three-quarters of new infections in the 15-24 years age group in the region. Approximately 700 000 children younger than 15 years were newly in--fected with the virus in 2005.1 Almost 90% of these newly infected children were born to HIV-infected mothers and acquired HIV during pregnancy, labour and delivery, or via breastfeeding. 1,3,4 Interventions to reduce the transmission

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High HIV-1 incidence in young women masked by stable overall seroprevalence among childbearing women in Kinshasa, Zaïre

Cited by 81 publications

References 0 publications

Estimating HIV hazard rates from cross-sectional HIV prevalence data

Estimating HIV hazard rates from cross-sectional HIV prevalence data

Reproductive Health and Behavior, HIV/AIDS, and Poverty in Africa

Preventing vertical transmission of HIV in Kinshasa, Democratic Republic of the Congo: a baseline survey of 18 antenatal clinics

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