Can data from programs for the prevention of mother-to-child transmission of HIV be used for HIV surveillance in Kenya?
Can data from programs for the prevention of mother-to-child transmission of HIV be used for HIV surveillance in Kenya?
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DOI：
10.1177/003335490612100609
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发表时间：
2006-11-01
影响因子：
3.3
通讯作者：
Diaz, Theresa
中科院分区：
文献类型：
--
作者：
Seguy, Nicole;Hladik, Wolfgang;Diaz, Theresa
目标。在非洲，艾滋病毒监测是在产前诊所（ANC）的参与者中使用无关联匿名检测（UAT）进行的。在肯尼亚，对预防母婴传播（PMTCT）项目数据用于艾滋病监测的效用进行了评估。在同一诊所和同一时间（2003年UAT调查）比较了UAT和PMTCT的数据。预防母婴传播艾滋病毒检测的接受率被定义为在ANC监测期间第一次到ANC就诊的ANC与会者中接受艾滋病毒检测的人数。计算比值比和95%置信区间以确定人口统计学特征与HIV检测接受度之间的关系。在39个ANC-UAT站点中，6个站点有预防母婴传播数据。PMTCT数据记录在几个不同质量的日志中。在预防母婴传播方面，2239名妇女接受了艾滋病毒检测，1258名（56%）接受了检测；在UAT，有1852名女性被抽样。基于uat的HIV感染率中位数为12.8%（范围，8.1%-26.3%），而PMTCT的HIV检测接受度中位数为14.4%（范围，7.0%-27.2%），各诊所PMTCT的接受度为48% - 69%，初产妇比多胎孕妇更容易感染。由于预防母婴传播数据质量参差不齐，预防母婴传播的艾滋病毒检测接受程度参差不齐，目前在肯尼亚，基于预防母婴传播的艾滋病毒流行率估计无法取代基于uat的估计。
Objective. In Africa, HIV surveillance is conducted among antenatal clinic (ANC) attendees using unlinked-anonymous testing (UAT). In Kenya, the utility of prevention of mother-to-child transmission (PMTCT) program data for HIV surveillance was evaluated.Methods. UAT and PMTCT data were compared at the same clinics and for the same time (2003 UAT survey) period. The HIV testing uptake for PMTCT was defined as the number of ANC attendees tested for HIV out of those who had their first ANC visit during the ANC surveillance period. Odds ratios and 95% confidence intervals were calculated to determine associations between demographic characteristics and HIV testing acceptance.Results. Of 39 ANC-UAT sites, six had PMTCT data. PMTCT data were recorded across several logbooks with varying quality. For PMTCT, 2,239 women were offered HIV testing and 1,258 (56%) accepted; for UAT, 1,852 women were sampled. Median UAT-based HIV prevalence was 12.8% (range, 8.1%-26.3%) compared with 14.4% (range, 7.0%-27.2%) in PMTCT HIV testing acceptance for PMTCT ranged from 48% to 69% across clinics, and was more likely among primigravidae than multigravidae.Conclusion. Because of varying PMTCT data quality and varying HIV testing acceptance for PMTCT, PMTCT-based HIV prevalence estimates cannot currently replace UAT-based estimates in Kenya.