HIV trends in African blood donors.

OBJECTIVES

To assess trends over the last 12 years in HIV-1/HIV-2 seroprevalence among blood donors in African nations and to correlate trends with national AIDS policies, with the purpose of preventing future cases.

METHODS

Using collated data of African seroepidemiologic studies published by the U.S. Bureau of the Census, we established a best-fit linear trend, determined by regression analysis of HIV-1 and HIV-2 seroprevalence values for African blood donors against time, with adjustments for sample size of reported studies.

RESULTS

Among 38 nations with sufficient data, 11 showed increases in HIV-1 seroprevalence, six showed decreases and 21 showed no significant changes. Decreases were seen primarily in nations with a high HIV-1 seroprevalence before 1989 (P<0.001, Chi-square). HIV-2 seroprevalence decreased in all nations where it was tested except Nigeria. There was a moderate correlation between decreases in HIV-1 and HIV-2 seroprevalence values (correlation coefficient = 0.39). No significant correlations between HIV policies and subsequent HIV-1 seroprevalence trends among blood donors and HIV patients were detected.

CONCLUSIONS

A great disparity exists in trends in HIV-1 seroprevalence among African nations. HIV-2 seroprevalence is consistently decreasing throughout most of West Africa, the exception being Nigeria. The absence of any significant correlation between HIV seroprevalence trends and healthcare policies suggests that other factors are more influential than national policy in determining such trends and, by extrapolation, trends in AIDS prevalence.