Sandøy Ingvild F, Kvåle Gunnar, Michelo Charles, Fylkesnes Knut
Centre for International Health, University of Bergen, Bergen, Norway.
Trop Med Int Health. 2006 Jun;11(6):917-28. doi: 10.1111/j.1365-3156.2006.01629.x.
To describe regional variation in human immunodefffeciency virus (HIV) prevalence trends in the period 1994-2002 and to assess the effects on prevalence trends of residence, educational level and age, and potential interaction between these variables.
The data were from the national HIV sentinel surveillance system comprising information collected using interviews and unlinked anonymous testing of blood among pregnant women attending antenatal clinics in 22 sites in 1994, 1998 and 2002.
There was a decline in HIV prevalence in the age group 15-24 years in the period 1994-2002 both in rural (by 11%) and urban (by 26%) areas. The decline was strongest among highly educated women. However, this overall decline masked striking differences at community (site) levels with clearly declining epidemics in many sites contrasted by increasing epidemics in some and stability in others. Urban/rural residence, age, educational attainment, marital status and parity were factors closely associated with HIV infection. Having born many children was associated with lower risk of being infected by HIV, even in the age group 15-24.
The HIV prevalence decline in young women is likely to reflect a drop in incidence during the period. However, there were sharp geographical contrasts in trends. Such local contrasts probably indicate differences in effectiveness of preventive interventions. Understanding factors and mechanisms explaining the differences will be of critical importance to better guide preventive interventions.
描述1994 - 2002年期间人类免疫缺陷病毒（HIV）流行趋势的地区差异，并评估居住地区、教育水平和年龄对流行趋势的影响，以及这些变量之间的潜在相互作用。
数据来自国家HIV哨点监测系统，该系统包括1994年、1998年和2002年在22个地点对参加产前诊所的孕妇进行访谈收集的信息以及不关联的匿名血液检测。
1994 - 2002年期间，15 - 24岁年龄组的HIV流行率在农村地区（下降11%）和城市地区（下降26%）均有所下降。在受过高等教育的女性中下降最为明显。然而，这种总体下降掩盖了社区（地点）层面的显著差异，许多地点的疫情明显下降，而一些地点的疫情上升，其他一些地点则保持稳定。城乡居住地区、年龄、教育程度、婚姻状况和生育次数是与HIV感染密切相关的因素。生育多个孩子与感染HIV的风险较低相关，即使在15 - 24岁年龄组也是如此。
年轻女性中HIV流行率的下降可能反映了该时期发病率的下降。然而，趋势存在明显的地理差异。这种局部差异可能表明预防干预措施效果的差异。了解解释这些差异的因素和机制对于更好地指导预防干预措施至关重要。
