Adjusting ante-natal clinic data for improved estimates of HIV prevalence among women in sub-Saharan Africa
Adjusting ante-natal clinic data for improved estimates of HIV prevalence among women in sub-Saharan Africa
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DOI：
10.1097/00002030-200012010-00014
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发表时间：
2000-12-01
期刊：
影响因子：
3.8
通讯作者：
Urassa, M
中科院分区：
文献类型：
--
作者：
Zaba, BW;Carpenter, LM;Urassa, M
目的：找到一种简单且可靠的方法，对产前门诊的艾滋病病毒（HIV）感染率数据进行调整，以代表同一年龄段普通女性人群的感染率，同时考虑到HIV感染状况对生育能力的影响。
背景：对孕妇和普通社区女性的HIV感染率比较表明，后者的感染率明显高于前者。需要一种针对特定人群的人口统计学和流行病学情况的调整程序，最大限度地利用在产前门诊容易收集的数据或从二手资料中广泛获取的数据。
方法：利用生育间隔长度数据来考虑HIV阳性女性的生育能力低下情况。为考虑不育情况，将在避孕措施使用水平相似的人群中进行社区调查所获得的有生育能力和不育女性的相对HIV感染率比值应用于描述无生育风险人群结构的人口统计学调查数据。
结果：对于避孕措施使用率低的人群，根据人口结构的不同，该程序得出的普通女性HIV感染率估计值比观察到的产前感染率高35% - 65%。利用在基塞萨（坦桑尼亚）和马萨卡（乌干达）收集的普通人群感染率数据对结果进行了验证。对于避孕措施使用率高的人群，调整后的值从高出15%到低5%不等，但到目前为止只能进行有限的验证。
结论：该程序适用于估计避孕措施使用率低的人群中普通女性的HIV感染率，但避孕措施使用率高的变体在广泛应用之前还需要进一步测试。（C）2000年利平科特 - 威廉姆斯和威尔金斯出版社。
Objectives: To find a simple and robust method for adjusting ante-natal clinic data on HIV prevalence to represent prevalence in the general female population in the same age range, allowing for fertility differences by HIV status.Background: HIV prevalence comparisons for pregnant women and women in the general community show that prevalence in the latter is significantly higher than in the former. An adjustment procedure is needed that is specific for the demographic and epidemiological circumstances of a particular population, making maximum use of data that can easily be collected in ante-natal clinics or are widely available from secondary sources.Methods: Birth interval length data are used to allow for subfertility among HIV-positive women. To allow for infertility, relative HIV prevalence ratios for fertile and infertile women obtained in community surveys in populations with similar levels of contraception use are applied to demographic survey data that describe the structure of the population not at risk of child-bearing.Results: For populations with low contraception use, the procedure yields estimates of general female HIV prevalence of 35-65% higher than the observed ante-natal prevalence, depending on population structure. Results were verified using general population prevalence data collected in Kisesa (Tanzania) and Masaka (Uganda). For high contraception use populations, adjusted values range from 15% higher to 5% lower, but only limited verification has been possible so far.Conclusions: The procedure is suitable for estimating general female HIV prevalence in low contraception use populations, but the high contraception variant needs further testing before it can be applied widely. (C) 2000 Lippincott Williams & Wilkins.