National population based HIV prevalence surveys in sub-Saharan Africa:: results and implications for HIV and AIDS estimates
National population based HIV prevalence surveys in sub-Saharan Africa:: results and implications for HIV and AIDS estimates
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DOI：
10.1136/sti.2006.019901
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发表时间：
2006-06-01
影响因子：
3.6
通讯作者：
Ghys, P. D.
中科院分区：
文献类型：
--
作者：
Garcia-Calleja, J. M.;Gouws, E.;Ghys, P. D.
背景：对到产前诊所(ANCs)就诊的孕妇进行哨兵监测是了解撒哈拉以南非洲艾滋病毒趋势的主要信息来源。这些数据还被用来生成国家艾滋病毒和艾滋病估计数。新的技术和资源使许多国家能够进行全国性的人口调查，其中包括艾滋病毒流行率的测量，作为艾滋病流行的另一个信息来源。方法：作者回顾了自2001年以来在撒哈拉以南非洲地区开展的19个国家的20项全国性人口调查的报告。他们检查了抽样方法、艾滋病毒检测和应答率以及女性：男性和城市：农村的流行率。结果：全国人口调查在质量上存在较大差异，表现在家庭回复率(75.4%~99.7%)、女性检测率(68.2%~97.3%)和男性检测率(62.2%~95.4%)，而部分调查缺乏详细的回应信息。虽然个别国家的女性：男性和城市：农村患病率的95%可信区间很大，但综合调查结果的女性与男性的中位数比率为1.5，城市与农村的中位数比率为1.7。假设没有应答者的HIV感染率是完全参与调查的人的两倍，那么个人的无应答者可能会导致调整后的HIV流行率比观察到的流行率高1.03到1.34倍。结论：基于人口的调查可以提供关于HIV流行率水平和分布的有用信息。这些信息正被用来改进国家对艾滋病毒和艾滋病的估计。进一步完善数据收集、分析和报告，再加上较高的参与率，可以进一步改善国家和区域一级的艾滋病毒和艾滋病估计。
Background: Sentinel surveillance among pregnant women attending antenatal clinics (ANCs) has been the main source of information on HIV trends in sub-Saharan Africa. These data have also been used to generate national HIV and AIDS estimates. New technologies and resources have allowed many countries to conduct national population based surveys that include HIV prevalence measurement, as an additional source of information on the AIDS epidemic.Methods: The authors reviewed the reports of 20 national population based surveys from 19 countries carried out in sub-Saharan Africa since 2001. They examined the sampling methodology, HIV testing and response rates, and female: male and urban: rural prevalence ratios. They also constructed adjusted prevalence scenarios assuming different relative risks for survey non-responders.Results: The national population based surveys vary considerably in quality, as reflected in the household response rate (ranging from 75.4% to 99.7%), women's testing rate (ranging from 68.2% to 97.3%), and men's testing rate (ranging from 62.2% to 95.4%), while for some surveys detailed response information is lacking. While 95% confidence intervals around the female: male and urban: rural prevalence ratios in individual countries are large, the median female: male ratio of the combined set of surveys results is 1.5 and the median urban: rural ratio 1.7. A scenario assuming that non-responders have twice the HIV prevalence of those who fully participated in the survey suggests that individual non-response could result in an adjusted HIV prevalence 1.03 to 1.34 times higher than the observed prevalence.Conclusions: Population based surveys can provide useful information on HIV prevalence levels and distribution. This information is being used to improve national HIV and AIDS estimates. Further refinements in data collection, analysis, and reporting, combined with high participation rates, can further improve HIV and AIDS estimates at national and regional level.