HIV Incidence Remains High in KwaZulu-Natal, South Africa: Evidence from Three Districts
HIV Incidence Remains High in KwaZulu-Natal, South Africa: Evidence from Three Districts
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DOI：
10.1371/journal.pone.0035278
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发表时间：
2012-04-19
期刊：
影响因子：
3.7
通讯作者：
van de Wijgert, Janneke
中科院分区：
文献类型：
--
作者：
Nel, Annalene;Mabude, Zonke;van de Wijgert, Janneke
背景：2007年10月至2010年2月，为了准备阴道杀菌剂试验，对南非拉迪史密斯、埃登代尔和皮恩敦的性活跃妇女的艾滋病毒流行率和发病率进行了评估。方法/主要结果：对18-35岁、未知艾滋病毒阳性或怀孕的性活跃妇女进行横断面检测，以确定艾滋病毒和怀孕的流行率(拉迪史密斯为798人，埃登代尔为1,084人，皮恩敦为891人)。其中，大约300名确诊的未怀孕、HIV阴性的妇女随后在每个临床研究中心(CRC)登记参加了为期12个月的队列研究，每季度进行一次研究访问。队列研究中的女性被要求使用避孕套和荷尔蒙避孕方法。在基线横断面调查中，艾滋病毒感染率很高：Ladysmith为42%，Edendale为46%，Pinown为41%。在每一项研究中，约90%的参与者报告在过去3个月中有一个性伴侣，但只有14%-30%的人表示，他们确定他们的性伴侣中没有一个是艾滋病毒阳性的。以12个月以上血清转换为基础的HIV感染率，Ladysmith为14.8/100人年(95%CI 9.7，19.8)，Edendale为6.3/100 Py(95%CI 3.2，9.4)，Pinown为7.2/100 Py(95%CI 3.7，10.7)。在避孕措施使用率较高的情况下，12个月妊娠率：Ladysmith为5.7/100 Py(95%CI 2.6，8.7)，Edendale为3.1/100 Py(95%CI 0.9，5.2)，Pinetown为6.3/100 Py(95%CI 3.0，9.6)。
Background: HIV prevalence and incidence among sexually active women in peri-urban areas of Ladysmith, Edendale, and Pinetown, KwaZulu-Natal, South Africa, were assessed between October 2007 and February 2010 in preparation for vaginal microbicide trials.Methodology/Principal Findings: Sexually active women 18-35 years, not known to be HIV-positive or pregnant were tested cross-sectionally to determine HIV and pregnancy prevalence (798 in Ladysmith, 1,084 in Edendale, and 891 in Pinetown). Out of these, approximately 300 confirmed non-pregnant, HIV-negative women were subsequently enrolled at each clinical research center (CRC) in a 12-month cohort study with quarterly study visits. Women in the cohort studies were required to use a condom plus a hormonal contraceptive method. HIV prevalence rates in the baseline cross-sectional surveys were high: 42% in Ladysmith, 46% in Edendale and 41% in Pinetown. Around 90% of study participants at each CRC reported one sex partner in the last 3 months, but only 14-30% stated that they were sure that none of their sex partners were HIV-positive. HIV incidence rates based on seroconversions over 12 months were 14.8/100 person-years (PY) (95% CI 9.7, 19.8) in Ladysmith, 6.3/100 PY (95% CI 3.2, 9.4) in Edendale, and 7.2/100 PY (95% CI 3.7, 10.7) in Pinetown. The 12-month pregnancy incidence rates (in the context of high reported contraceptive use) were: 5.7/100 PY (95% CI 2.6, 8.7) in Ladysmith, 3.1/100 PY (95% CI 0.9, 5.2) in Edendale and 6.3/100 PY (95% CI 3.0, 9.6) in Pinetown.Conclusions/Significance: HIV prevalence and incidence remain high in peri-urban areas of KwaZulu-Natal.