International Partnership for Microbicides, Silver Spring, Maryland United States of America.
PLoS One. 2012;7(4):e35278. doi: 10.1371/journal.pone.0035278. Epub 2012 Apr 19.
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.
为准备阴道杀微生物剂试验，2007 年 10 月至 2010 年 2 月期间，在南非夸祖鲁-纳塔尔省Ladysmith、Edendale 和 Pinetown 的城乡结合部对性活跃妇女进行了艾滋病毒流行率和发病率评估。
方法/主要发现：对 18-35 岁、艾滋病毒检测呈阴性或未怀孕的性活跃妇女进行了横断面检测，以确定艾滋病毒和妊娠流行率（Ladysmith 为 798 人，Edendale 为 1084 人，Pinetown 为 891 人）。在此基础上，每个临床研究中心（CRC）随后招募了大约 300 名经确认未怀孕且艾滋病毒检测呈阴性的妇女，进行为期 12 个月的队列研究，每季度进行一次研究访问。队列研究中的妇女需要使用避孕套加激素避孕方法。基线横断面调查中的艾滋病毒流行率较高：Ladysmith 为 42%，Edendale 为 46%，Pinetown 为 41%。每个 CRC 的研究参与者中约有 90%在过去 3 个月内报告有一个性伴侣，但只有 14-30%的人表示他们确信其性伴侣中没有人艾滋病毒检测呈阳性。根据 12 个月的血清转化率，Ladysmith 的艾滋病毒发病率为 14.8/100 人年（95%CI9.7，19.8），Edendale 为 6.3/100 人年（95%CI3.2，9.4），Pinetown 为 7.2/100 人年（95%CI3.7，10.7）。在高报告避孕使用率的背景下，12 个月的妊娠发病率为：Ladysmith 为 5.7/100 人年（95%CI2.6，8.7），Edendale 为 3.1/100 人年（95%CI0.9，5.2），Pinetown 为 6.3/100 人年（95%CI3.0，9.6）。
结论/意义：夸祖鲁-纳塔尔省城乡结合部的艾滋病毒流行率和发病率仍然很高。
