Barcelona Centre for International Heath Research (CRESIB, Hospital Clínic, University of Barcelona), Barcelona, Spain.
HIV Med. 2012 Nov;13(10):581-8. doi: 10.1111/j.1468-1293.2012.01018.x. Epub 2012 Apr 15.
Southern African countries have borne the brunt of the HIV/AIDS pandemic. Monitoring epidemiological dynamics is critical to identify the populations at greatest risk of infection and to guide control strategies.
A cross-sectional community-based study to determine age- and sex-specific HIV prevalence among individuals aged 18-47 years was carried out in Manhiça, southern Mozambique. Participants were randomly selected from the demographic surveillance system in place in the area and voluntary HIV counselling and testing were offered at home. In addition, HIV prevalence estimates from the antenatal clinic (ANC) were collected prospectively.
A total of 839 individuals were invited to participate in the study. Of these, 722 were recruited (50.7% women). The overall HIV prevalence in the community was 39.9% [95% confidence interval (CI) 35.9-43.8%]. By age, the prevalence was 23.2% (95% CI 17.9-28.6%) in individuals aged 18-27 years, 41.2% (95% CI 35.6-48.3%) in those aged 28-37 years and 44.8% (95% CI 38.4-51.2%) in those aged 38-47 years. HIV prevalence was higher among women than men in all age groups. The overall HIV prevalence estimate for women in the community (43.1%; 95% CI 37.6-48.5%) was 1.4 times higher than that for those attending the ANC (29.4%; 95% CI 26.7-32.0%).
The high HIV prevalence found in this region suggests that the epidemic is in a mature stable phase. The lower rates in the ANC than in the community suggest that ANC evaluations may underestimate community HIV prevalence. Resources to monitor HIV infection dynamics are needed to guide targeted control strategies in countries in which the epidemic exacts the greatest toll.
南部非洲国家首当其冲地遭受了艾滋病毒/艾滋病的大流行。监测流行病学动态对于确定感染风险最大的人群以及指导控制策略至关重要。
在莫桑比克南部的马希奇卡进行了一项横断面社区为基础的研究，旨在确定年龄和性别特异性的 18-47 岁个体的艾滋病毒流行率。参与者从该地区现有的人口监测系统中随机选择，并在家中提供自愿的艾滋病毒咨询和检测。此外，还前瞻性地收集了来自产前诊所（ANC）的艾滋病毒流行率估计值。
共邀请了 839 人参加研究。其中，722 人被招募（50.7%为女性）。社区内总的艾滋病毒流行率为 39.9%[95%置信区间（CI）为 35.9-43.8%]。按年龄划分，18-27 岁的人群中流行率为 23.2%（95%CI 为 17.9-28.6%），28-37 岁的人群中流行率为 41.2%（95%CI 为 35.6-48.3%），38-47 岁的人群中流行率为 44.8%（95%CI 为 38.4-51.2%）。所有年龄组的女性艾滋病毒流行率均高于男性。社区中女性的艾滋病毒总流行率估计值（43.1%；95%CI 为 37.6-48.5%）比参加 ANC 的女性高出 1.4 倍（29.4%；95%CI 为 26.7-32.0%）。
该地区发现的高艾滋病毒流行率表明疫情正处于成熟稳定阶段。ANC 中的低流行率表明 ANC 评估可能低估了社区中的艾滋病毒流行率。需要监测艾滋病毒感染动态的资源，以指导在疫情最严重的国家实施有针对性的控制策略。
