FHI 360, Durham, North Carolina, United States of America.
Chókwè Health Research and Training Center/Centro de Investigação e Treino em Saúde de Chókwè (CITSC), National Institute of Health, Mozambique.
PLoS One. 2014 May 19;9(5):e97547. doi: 10.1371/journal.pone.0097547. eCollection 2014.
Reliable HIV incidence estimates for Mozambique are limited. We conducted a prospective HIV incidence study as part of a clinical research site development initiative in Chókwè district, Gaza Province, southern Mozambique.
Between June 2010 and October 2012, we recruited women at sites where women at higher risk of HIV infection would likely be found. We enrolled and tested 1,429 sexually active women in the screening phase and 479 uninfected women in the prospective phase. Participants were scheduled for 12+ months follow-up, when they underwent face-to-face interviews, HIV counseling and testing, and pregnancy testing. We observed a total of 373.1 woman-years (WY) of follow-up, with mean (median) of 9.4 (9.7) women-months per participant.
The prevalence of HIV was 29.4% (95% confidence interval [CI]: 27.0-31.8%). In multivariable logistic regression analysis, factors that remained significantly associated with prevalent HIV were: older age (OR: 0.6; 95% CI: 0.4-0.7), lower educational level (OR: 0.4; 95% CI: 0.3-0.7), and using hormonal contraception (OR: 0.6; 95% CI: 0.4-0.7) or condoms (OR: 0.5; 95% CI: 0.3-0.7). We observed an HIV incidence rate of 4.6 per 100 WY (95% CI: 2.7, 7.3). The HIV incidence was 4.8 per 100 WY (95% CI: 2.5, 8.3) in women aged 18-24 years, 4.5 per 100 WY (95% CI: 1.2, 11.4) in women aged 25-29 years and 3.2 per 100 WY (95% CI: 0.1, 18.0) in the 30-35 years stratum. None of the demographic factors or time-varying behavioral factors examined was significantly associated with incident HIV infection in bivariable analysis at p ≤ 0.10.
We found a high HIV incidence among sexually active young women in Chókwè, Mozambique. HIV prevention programs should be strengthened in the area, with more comprehensive reproductive health services, regular HIV testing, condom promotion, and messaging about multiple sexual partners.
莫桑比克可靠的艾滋病毒发病率估计数据有限。我们在加扎省乔克韦区开展了一项艾滋病毒发病率前瞻性研究，这是临床研究机构发展倡议的一部分。
2010 年 6 月至 2012 年 10 月，我们在艾滋病毒感染风险较高的女性可能会被发现的地点招募女性。我们在筛查阶段招募并检测了 1429 名活跃性女性，在前瞻性阶段招募了 479 名未感染的女性。参与者被安排进行 12 个月以上的随访，期间他们接受面对面访谈、艾滋病毒咨询和检测以及妊娠检测。我们共观察了 373.1 名女性（WY）的随访，每名参与者的平均（中位数）为 9.4（9.7）个女性月。
艾滋病毒的流行率为 29.4%（95%置信区间[CI]：27.0-31.8%）。在多变量逻辑回归分析中，与现患艾滋病毒相关的显著因素包括：年龄较大（OR：0.6；95%CI：0.4-0.7）、教育程度较低（OR：0.4；95%CI：0.3-0.7）、使用激素避孕（OR：0.6；95%CI：0.4-0.7）或避孕套（OR：0.5；95%CI：0.3-0.7）。我们观察到每 100 WY 有 4.6 例艾滋病毒发病率（95%CI：2.7，7.3）。在年龄为 18-24 岁的女性中，艾滋病毒发病率为每 100 WY 4.8（95%CI：2.5，8.3），在年龄为 25-29 岁的女性中为每 100 WY 4.5（95%CI：1.2，11.4），在 30-35 岁的女性中为每 100 WY 3.2（95%CI：0.1，18.0）。在双变量分析中，p≤0.10 时，没有任何人口统计学因素或随时间变化的行为因素与艾滋病毒新发感染显著相关。
我们在莫桑比克乔克韦发现了性活跃的年轻女性中较高的艾滋病毒发病率。该地区应加强艾滋病毒预防计划，提供更全面的生殖健康服务、定期艾滋病毒检测、推广避孕套，并宣传多个性伴侣的问题。
