FHI 360, Durham, North Carolina, United States of America ; United States Military HIV Research Program (MHRP), Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, Maryland, United States of America.
Universidade Católica de Moçambique/Catholic University of Mozambique, (UCM) Centro de Investigação de Doenças Infecciosas/Research Center for Infectious Diseases (CIDI), Beira, Mozambique.
PLoS One. 2014 Jan 27;9(1):e84979. doi: 10.1371/journal.pone.0084979. eCollection 2014.
HIV is prevalent in Sofala Province, Mozambique. To inform future prevention research, we undertook a study in the provincial capital (Beira) to measure HIV incidence in women at higher risk of HIV and assess the feasibility of recruiting and retaining them as research participants.
Women age 18-35 were recruited from schools and places where women typically meet potential sexual partners. Eligibility criteria included HIV-seronegative status and self-report of at least 2 sexual partners in the last month. History of injection drug use was an exclusion criterion, but pregnancy was not. Participants were scheduled for monthly follow-up for 12 months, when they underwent face-to-face interviews, HIV counseling and testing, and pregnancy testing.
387 women were eligible and contributed follow-up data. Most were from 18-24 years old (median 21). Around one-third of participants (33.8%) reported at least one new sexual partner in the last month. Most women (65.5%) reported not using a modern method of contraception at baseline. Twenty-two women seroconverted for a prospective HIV incidence of 6.5 per 100 woman-years (WY; 95% confidence interval (CI): 4.1-9.9). Factors associated with HIV seroconversion in the multivariable analysis were: number of vaginal sex acts without using condoms with partners besides primary partner in the last 7 days (hazard ratio (HR) 1.7; 95% CI: 1.2-2.5) and using a form of contraception at baseline other than hormonal or condoms (vs. no method; HR 25.3; 95% CI: 2.5-253.5). The overall retention rate was 80.0% for the entire follow-up period.
We found a high HIV incidence in a cohort of young women reporting risky sexual behavior in Beira, Mozambique. HIV prevention programs should be strengthened. Regular HIV testing and condom use should be encouraged, particularly among younger women with multiple sexual partners.
莫桑比克索法拉省 HIV 感染较为普遍。为了为未来的预防研究提供信息，我们在省会贝拉进行了一项研究，以衡量高危 HIV 感染风险的女性中的 HIV 发病率，并评估招募和留住她们作为研究参与者的可行性。
从学校和女性通常与潜在性伴侣见面的地方招募 18-35 岁的女性。入选标准包括 HIV 血清阴性和自我报告的上个月至少有 2 个性伴侣。有注射吸毒史是排除标准，但怀孕不是。参与者计划每月随访 12 个月，期间进行面对面访谈、HIV 咨询和检测以及妊娠检测。
387 名女性符合条件并提供了随访数据。大多数女性年龄在 18-24 岁之间（中位数为 21 岁）。大约三分之一的参与者（33.8%）报告上个月至少有一个新的性伴侣。大多数女性（65.5%）在基线时报告未使用现代避孕方法。22 名女性血清转换，预期 HIV 发病率为每 100 名女性年 6.5 例（95%置信区间：4.1-9.9）。多变量分析中与 HIV 血清转换相关的因素是：在过去 7 天内与主要伴侣以外的伴侣进行无保护阴道性行为的次数（危险比 1.7；95%置信区间：1.2-2.5）和在基线时使用除激素或避孕套以外的避孕方法（与无方法相比；HR 25.3；95%置信区间：2.5-253.5）。整个随访期间的总体保留率为 80.0%。
我们发现莫桑比克贝拉的一组报告高危性行为的年轻女性 HIV 发病率较高。应加强 HIV 预防计划。应鼓励定期进行 HIV 检测和使用避孕套，特别是在有多个性伴侣的年轻女性中。
