The adult prevalence of HIV in Zambia: results from a population based mobile testing survey conducted in 2013–2014
Tóm tắt
To estimate the adult prevalence of HIV among the adult population in Zambia and determine whether demographic characteristics were associated with being HIV positive. A cross sectional population based survey to asses HIV status among participants aged 15 years and above in a national tuberculosis prevalence survey. Counselling was offered to participants who tested for HIV. The prevalence was estimated using a logistic regression model. Univariate and multivariate associations of social demographic characteristics with HIV were determined. Of the 46,099 individuals who were eligible to participate in the survey, 44,761 (97.1 %) underwent pre-test counselling for HIV; out of which 30,605 (68.4 %) consented to be tested and 30, 584 (99.9 %) were tested. HIV prevalence was estimated to be 6.6 % (95 % CI 5.8–7.4); with females having a higher prevalence than males 7.7 % (95 % CI 6.8–8.7) versus 5.2 % (95 % CI 4.4–5.9). HIV prevalence was higher among urban (9.8 %; 95 % CI 8.8–10.7) than rural residents (5.0 %; 95 % CI 4.3–5.8). The risk of HIV was double among urban dwellers than among their rural counterparts. Being divorced or widowed was associated with a threefold higher risk of being HIV positive than being never married. The risk of being HIV positive was four times higher among those with tuberculosis than those without tuberculosis. HIV prevalence was lower than previously estimated in the country. The burden of HIV showed sociodemographic disparities signifying a need to target key populations or epidemic drivers. Mobile testing for HIV on a national scale in the context of TB prevalence surveys could be explored further in other settings.
Tài liệu tham khảo
UNAIDS. ‘Fact sheet: 2014 statistics’. 2015. [Cited 2015 Oct 29]. Available from: http://www.unaids.org/sites/default/files/media_asset/20150714_FS_MDG6_Report_en.pdf.
Avert [Internet].Brighton: Averting HIV and AIDS. 2015. [Cited 2015 Oct 29]. Available from:http://www.avert.org/professionals/hiv-around-world/global-statistics.
UNAIDS. How AIDS changed everything’. 2015. [Cited 2015 Oct 29]. Available from:http://www.unaids.org/sites/default/files/media_asset/MDG6Report_en.pdf.
World Health Organization(WHO). ‘HIV/AIDS’. 2015. [Cited 2015 Oct 29]. Available from: http://www.who.int/mediacentre/factsheets/fs360/en/.
Bassett IV, Govindasamy D, Erlwanger AS, et al. Mobile HIV screening in Cape Town South Africa: clinical impact cost and cost-effectivies. PLoS One. 2014;9(1):85–197.
Sabapathy K, Van den Bergh R, Fidler S, et al. Uptake of home-based voluntary HIV testing in Sub-Saharan Africa: a systematic review and meta-analysis. PLoS Med. 2012;9(12):e1001351. doi:10.1371/journal.pmed.1001351.
Morin SF, Khumalo-Sakutukwa G, Charlebois ED, et al. Removing barriers to knowing HIV status: same day mobile HIV testing in Zambabwe. J Acquired Immune Defic. 2006;41:218–24.
Maheswaran H, Thulare H, Stanistreet D, et al. Starting a home and mobile HIV testing service in a rural area of South Africa. J Acquir Immune Defic Syndr. 2012;59(3):E43–6.
Sweat M, Morin S, Celentano D, et al. Community based intervention to increase HIV testing and case detection in people aged 16–32 years in Tanzania, Zimbabwe and Thailand(NIMH project accept, HPTN 043): a randomized study. Lancet Infect Dis. 2011;11:525–32.
Matovu JK, Makumbi FE. Expanding access to voluntary HIV counselling and testing in Sub-Saharan Africa: alternative approaches for improving uptake 2001–2007. Tro Med Intl Health. 2007;12:1315–22.
Peltzter K, Matseke G. Determinants of knowledge of HIV status in South Africa: results from a population-based survey. BMC Public Health. 2009;9:174.
Ostermann J, Reddy EA, Shorter MM, et al. Who tests, who doesn’t and why? Uptake of mobile HIV counseling and testing in the Kilimanjaro region of Tanzania. PLoS One. 2011;6:16–488.
Central Statistical Office [Zambia], Central Board of Health [Zambia], and ORC Macro. Zambia Demographic and Health Survey 2001–2002. Calverton, Maryland, USA: Central Statistical Office, Central Board of Health, and ORC macro. 2003.
Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. Zambia Demographic Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc. 2009.
Central Statistical Office (CSO) Zambia, Ministry of Health (MOH) Zambia and ICF International. Zambia Demographic Health Survey 2013/2014. Rockville, Maryland, USA: Central Statistical Office, Ministry of Heath, and ICF International. 2014.
Mishra V, Vaessen M, Boerma JT, et al. HIV testing in National population based surveys: experience from the demographic and health surveys. Bull World Health Organ. 2006;84(7):537–45.
Hensen B, Baggaley R, Wong VJ, et al. Factors associated with HIV testing and acceptance of an offer of home based testing by men in rural Zambia. AIDS behavior. 2015;19(3):492–504.
Parker LA, Jobanputra K, Rusike L, et al. Feasibility and effectiveness of two community based HIV testing models in rural Swaziland. Trop Med Int Health. 2015;20(7):893–902.
Suthar AB, Ford N, Bachanas PJ, et al. Towards Universal Voluntary HIV testing and counselling: a systematic review and meta-analysis of community based approaches. PLoS One. 2013;10(8):1371–496.
Grusky O, Roberts KJ, Swanson AN, et al. Staff strategies for improving HIV detection using mobile HIV rapid testing. Behav Med. 2010;35(4):101–11.
Menna T, Ali A. Prevalence of HIV/AIDS related parental death and its association with sexual behavior of secondary school youth in Addis Ababa, Ethiopia: a cross sectional study. BMC public health. 2014;14:1120.
Rakotoniana JS, Rakotomanga JD. Can churches play a role in combating the HIV/AIDS epidemic? A study of the attitudes of Christian religious leaders in Madagascar. Plos One. 2014;9(5):e97131.
Kapata N, Chanda-Kapata P, Grobusch MP, et al. Scale-up of TB and HIV programme collaborative activities in Zambia—a 10 year review. Trop Med Int Health. 2012;. doi:10.1111/j.1365-3156.2012.02981.x.
Chanda-Kapata P, Ngosa W, Moraes AN, et al. Decliners of provider-initiated HIV testing and counselling: characteristics of participants who refused HIV testing in a population survey in Zambia. Asian Pac Jour Trop Med. 2015;5(8):689–93.