The George Institute for Global Health and Research, University of New South Wales, Level 5 - 1 King Street, Sydney, Newtown NSW, 2042, Australia.
Department of Public Health, Walter Sisulu University, Mthatha, South Africa.
BMC Infect Dis. 2021 Jan 13;21(1):61. doi: 10.1186/s12879-020-05744-7.
To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalence of HIV among women attending antenatal care and further determine spousal support during antenatal care attendance in rural areas in Eastern Cape province, South Africa.
A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p≤0.05 for statistical significance.
A total of 343 participants were included in the final analysis. The antenatal HIV prevalence was 38.2% (95%CI: 33.2-43.9). For 75% of the women, the HIV diagnosis was made 141 days before the date of the interview (median=77 days, interquartile range=42-141 days). Participants between the age of 30 to 39 years were 50% more likely to be HIV positive compared to those who were between the age of 20 to 29, these differences were statistically significant (PR=1.5; p-value=0.001). Furthermore, self-employed women were 30% less likely to be HIV positive when compared to unemployed participants, this was also statistically significant (PR=0.7; p-value< 0.0001).
Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high in this population, coupled with no spousal attendance in antenatal care. It is important to move beyond awareness about the HIV status to actionable strategies of reducing the HIV incident cases. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.
有效降低垂直传播的 HIV 需要降低孕妇中 HIV 的流行率和发病率，并充分了解其流行病学。本研究旨在确定在南非东开普省农村地区接受产前护理的妇女中 HIV 的流行率，并进一步确定在产前护理期间配偶的支持情况。
对四家初级保健机构接受产前护理的妇女进行了横断面研究，使用访谈者管理的问卷收集了社会人口统计学特征和病史信息。二项逻辑回归分析用于确定与 HIV 相关的因素，并估计患病率比（PR）。95%置信区间（95%CI）用于估计的精度；p≤0.05 表示具有统计学意义。
共有 343 名参与者被纳入最终分析。产前 HIV 流行率为 38.2%（95%CI：33.2-43.9）。对于 75%的女性，HIV 诊断是在接受采访日期的前 141 天做出的（中位数=77 天，四分位距=42-141 天）。与 20-29 岁年龄组相比，30-39 岁年龄组的参与者感染 HIV 的可能性增加了 50%，这具有统计学意义（PR=1.5；p 值=0.001）。此外，与失业参与者相比，自营职业的女性感染 HIV 的可能性降低了 30%，这也具有统计学意义（PR=0.7；p 值<0.0001）。
尽管进行了 100%的产前 HIV 检测，但该人群的产前 HIV 流行率仍然很高，并且在产前护理中没有配偶的参与。重要的是，要从了解 HIV 状况转变为采取行动减少 HIV 新发病例的策略。因此，重要的是保持警惕并监测可能与这种增加的流行率相关的母婴传播。
