Factors influencing the difference in HIV prevalence between antenatal clinic and general population in sub-Saharan Africa

Glynn, Judith R.; Buvé, Anne; Caraël, Michel; Musonda, Rosemary; Kahindo, Maina; Macauley, Isaac B.; Tembo, F.; Zekeng, Léopold

doi:10.1097/00002030-200109070-00016

Cited by 68 publications

(53 citation statements)

References 17 publications

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“…13 The data are presented in a spreadsheet, available from the author. I draw on antenatal/community comparisons for 12 regions in Cameroon, Kenya, Malawi, Tanzania, Uganda and Zambia as reported in the medical studies of Changalucha et al (2002), Crampin et al (2003), Fylkesnes et al (1998Fylkesnes et al ( , 2001, Glynn et al (2001), Gregson et al (2002), Kigadye et al (1993), andKillian et al (1999). I also match the DHS microdata on HIV infection rates for Ghana 2003 and Zambia 2001/02 to regional urban and rural antenatal surveillance surveys for the same years (as reported in the Census Bureau's HIV Surveillance Data Base) to produce another 37 regions.…”

Section: Census Bureau Uses the 2003 Unaids/who Estimation And Projecmentioning

confidence: 99%

In sorrow to bring forth children: fertility amidst the plague of HIV

Young

2007

J Econ Growth

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The HIV epidemic is lowering fertility in sub-Saharan Africa. This decline in fertility appears to reflect a fall in the demand for children, and not any adverse physiological consequences of the disease, as it is matched by changes in the expressed preference for children and the use of contraception, and is not significantly correlated with biological markers of sub-fecundity. A fall in fertility lowers dependency ratios and, for a given savings rate, increases future capital per person. These two effects more than offset the loss of prime working age adults and reduced human capital of orphaned children brought by the epidemic, allowing 27 of the nations of sub-Saharan Africa to cumulatively spend US$ 650 billion, or $5100 per dying adult AIDS victim, on patient care without harming the welfare of future generations. In sum, the behavioral response to the HIV epidemic creates the material resources to fight it. __________________In memory of Ho Hon and Nechama, terribly missed by us all. I am grateful to Ho Veng-Si, seminar participants at the Rand Corporation and the editors of this journal for many helpful comments.

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Section: Census Bureau Uses the 2003 Unaids/who Estimation And Projecmentioning

confidence: 99%

In sorrow to bring forth children: fertility amidst the plague of HIV

Young

2007

J Econ Growth

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“…Prevalence rates were nearly twice as high for females than males (8.7% for females and 4.6% for males), with urban rates much higher (7.5% for males and 12.3% for females) than rural rates (3.7% for males and 7.5% for females) (ORC Macro, 2005). The HIV prevalence among women attending prenatal clinics in Nairobi also increased from three percent in 1987, to 16 percent in 1995, before decreasing to 14 percent in 1999 and remaining at that level in 2001(UNAIDS, 2004. With a cure or vaccine for HIV not yet in sight, behavioral prevention mechanisms remain the only way to combat the epidemic (World Bank, 1997).…”

Section: Hiv Levels In Kenyamentioning

confidence: 99%

“…Young females in Kenya have higher levels of infection than do their male age mates (Glynn, Buve, Carael, Musonda, Kahinda, Macauley et al, 2001;ORC Macro, 2005). Lesser control over sexual relations, reproductive tracts that are more susceptible to infection than men's, and patterns of sexual networking all contribute to the higher infection rate for women (Ankrah, 1991;UNAIDS, 1999).…”

Section: Hiv Levels In Kenyamentioning

confidence: 99%

Cohabitation, marriage, and ‘sexual monogamy’ in Nairobi's slums

Hattori

Dodoo

2007

Social Science & Medicine

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The current study investigates the extent to which sexual exclusivity-the restriction of one's sexual engagements to a single partner-prevails across various marital status, union type, and co-residence categories among Nairobi's poorest residents, slum dwellers. This question is central to the spread of HIV in the increasingly urban and poor, high prevalence countries of sub-Saharan Africa, where transmission is primarily via heterosexual sex. In many circles, sexual exclusivity is considered a prominent feature of the marriage institution. Yet, marriage and cohabitation are often not easily distinguishable in sub-Saharan Africa, meaning that the frequent use, as a proxy, of the "in union" category, which includes married as well as cohabiting persons can, at best, be considered tenuous. Using the 2000 Nairobi Cross-Sectional Slum Survey (NCSS), this paper confirms that marriage is associated with higher reports of sexual exclusivity even in settings where poverty provokes risky behavior. The finding, here, is of lower risk of HIV infection for married respondents, with a smaller effect observed among non-married cohabiters. Converse to the implied benefits of marriage, though, women with co-wives are more likely to report multiple partners. The implications of these findings are discussed.

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“…[1][2][3][4][5] Increased funding combined with effective interventions, such as nevirapine for the prevention of mother-to-child transmission (PMTCT) 6,7 and voluntary counseling and testing (VCT), 8,9 should result in widespread utilization of these interventions. As access to PMTCT services grows, the feasibility and ethics of collecting anonymous antenatal clinic (ANC) data for HIV surveillance are being questioned.…”

mentioning

confidence: 99%

“…14 Although routine data from sources outside sentinel surveillance sites have been used elsewhere to monitor the epidemic, 18 the usefulness of the increasing volume of VCT programmatic data from sub-Saharan Africa and elsewhere has not been explored. 9,19,20 In addition to its potential utility for internal monitoring of VCT programs, VCT data may have distinct advantages that complement ANC surveillance data.…”

mentioning

confidence: 99%

Using HIV Voluntary Counseling and Testing Data for Monitoring the Uganda HIV Epidemic, 1992???2000

Baryarama¹,

Bunnell²,

Ransom³

et al. 2004

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective: To assess trends in the prevalence of HIV infection among voluntary counseling and testing (VCT) clients in Uganda and to describe the utility of VCT data for monitoring the HIV epidemic in 1992-2000. Methods:We analyzed routinely collected data from first-time VCT clients not reporting illness as a reason for testing. We developed a model adjusting for test site, couple testing, and premarital testing, assessed trends in adjusted prevalence of HIV infection and shifts in age-specific peak prevalence, and compared antenatal clinic (ANC) surveillance data and VCT prevalence trends.Results: Among 201,741 clients, adjusted prevalence of HIV infection declined from 23% in 1992 to 13% in 2000 (P < 0.001) (men, 17%-9% [P < 0.001]; women, 31%-18% [P < 0.001]). The prevalence declined for all age groups except men older than 39 years and women older than 34 years. The prevalence increased for women older than 39 years (P < 0.003). Between 1992 and 2000, peak prevalence declined for both men (31% to 24%) and women (44% to 41%), whereas the age at which the peak occurred increased for both men (36 to 41 years) and women (31 to 36 years). VCT and ANC prevalence trends were similar. Conclusion:In Uganda, the prevalence of HIV infection among male and female VCT clients declined from 1992 to 2000, similar to ANC surveillance data, but did not decline in older age groups. In regions with well-established VCT programs, VCT data may provide a useful and convenient tool for monitoring the HIV epidemic.

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Factors influencing the difference in HIV prevalence between antenatal clinic and general population in sub-Saharan Africa

Cited by 68 publications

References 17 publications

In sorrow to bring forth children: fertility amidst the plague of HIV

In sorrow to bring forth children: fertility amidst the plague of HIV

Cohabitation, marriage, and ‘sexual monogamy’ in Nairobi's slums

Using HIV Voluntary Counseling and Testing Data for Monitoring the Uganda HIV Epidemic, 1992???2000

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