Prevalence and Incidence of HIV Infection, Trends, and Risk Factors Among Persons Aged 15-64 Years in Kenya: Results From a Nationally Representative Study
Prevalence and Incidence of HIV Infection, Trends, and Risk Factors Among Persons Aged 15-64 Years in Kenya: Results From a Nationally Representative Study
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DOI：
10.1097/qai.0000000000000124
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发表时间：
2014-05-01
影响因子：
3.6
通讯作者：
Kim, Andrea A.
中科院分区：
文献类型：
--
作者：
Kimanga, Davies O.;Ogola, Samuel;Kim, Andrea A.
背景：利用全国调查中的人口、行为和生物学数据加强艾滋病毒监测，可以为有效评估和应对艾滋病毒流行提供信息。方法：2012年10月至2013年2月，我们对肯尼亚9个地理区域18个月至64岁的人群进行了两阶段整群抽样调查。参与者回答了问卷并提供了血液用于艾滋病毒检测。我们估计了 HIV 患病率、HIV 发病率，描述了过去 5 年 HIV 患病率的趋势，并确定了与 HIV 感染相关的因素。该分析仅限于 15-64 岁的人群。 结果：2012 年 HIV 患病率为 5.6% [95% CI：4.9 至 6.3]，较 2007 年显着下降，当时除东北地区外，HIV 患病率为 7.2%（95% CI：6.6 至 7.9）。 2012 年，艾滋病毒发病率为 0.5%（95% CI：0.2 至 0.9）。在女性中，与未确诊艾滋病毒感染相关的因素包括年龄在 35-39 岁、离婚或分居、居住在城市住所和尼安萨地区、自我认为感染艾滋病毒的风险中等、过去 12 个月内与最后一个性伴侣使用安全套以及报告一生有 4 个或以上性伴侣。在男性中，丧偶、过去 12 个月内与最后一个伴侣使用安全套以及未进行包皮环切均与未确诊的 HIV 感染有关。结论：自 2007 年以来，肯尼亚的 HIV 感染率有所下降。随着治疗机会的改善，在没有新感染和死亡率数据的情况下，解释 HIV 感染率变得更加困难。未确诊的艾滋病毒感染的相关性提供了重要信息，说明在哪里优先考虑预防干预措施，以减少艾滋病毒在更广泛人群中的传播。
Background: Enhanced HIV surveillance using demographic, behavioral, and biologic data from national surveys can provide information to evaluate and respond to HIV epidemics efficiently.Methods: From October 2012 to February 2013, we conducted a 2-stage cluster sampling survey of persons aged 18 months to 64 years in 9 geographic regions in Kenya. Participants answered questionnaires and provided blood for HIV testing. We estimated HIV prevalence, HIV incidence, described trends in HIV prevalence over the past 5 years, and identified factors associated with HIV infection. This analysis was restricted to persons aged 15-64 years.Results: HIV prevalence was 5.6% [95% confidence interval (CI): 4.9 to 6.3] in 2012, a significant decrease from 2007, when HIV prevalence, excluding the North Eastern region, was 7.2% (95% CI: 6.6 to 7.9). HIV incidence was 0.5% (95% CI: 0.2 to 0.9) in 2012. Among women, factors associated with undiagnosed HIV infection included being aged 35-39 years, divorced or separated, from urban residences and Nyanza region, self-perceiving a moderate risk of HIV infection, condom use with the last partner in the previous 12 months, and reporting 4 or more lifetime number of partners. Among men, widowhood, condom use with the last partner in the previous 12 months, and lack of circumcision were associated with undiagnosed HIV infection.Conclusions: HIV prevalence has declined in Kenya since 2007. With improved access to treatment, HIV prevalence has become more challenging to interpret without data on new infections and mortality. Correlates of undiagnosed HIV infection provide important information on where to prioritize prevention interventions to reduce transmission of HIV in the broader population.