安得拉邦产前门诊就诊者中 HIV 感染的次区域趋势（2003-2019 年）。

Sub-regional Trend of HIV Infection Among Antenatal Clinic Attendees in Andhra Pradesh (2003-2019).

机构信息

ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India.

Procrea Fertility Centre, Ontario, Canada.

出版信息

Curr HIV Res. 2022;20(4):327-336. doi: 10.2174/1570162X20666220805090501.

DOI:10.2174/1570162X20666220805090501

PMID:35929630

Abstract

INTRODUCTION

The analyses of local risks at sub-national levels and tailored interventions are being emphasized for effective HIV management. Andhra Pradesh (AP) is a high HIV prevalence state in India, with the second-highest number of People with HIV (PWH) and a consistent decline in HIV prevalence at the state level. Probing further into the region and district-wise levels and trends of HIV prevalence will provide critical insights into sub-regional epidemic patterns. Hence, this paper analyzes the regional and district-level trends of HIV prevalence among pregnant women attending antenatal clinics (ANC) from 2003 to 2019 in AP, South India.

METHODS

HIV prevalence data collected from pregnant women in AP during HIV Sentinel Surveillance (HSS) between 2003 and 2019 was used for trend analysis. The consistent sites were grouped into three regions (Coastal Andhra, Rayalaseema and Uttar Andhra), totaling 39 sites, including 21 rural and 18 urban sites. Regional and district-level HIV prevalence was analyzed using the Chisquare trend test, and spatial analysis was done using QGIS software. For the last three HSS rounds, HIV prevalence based on sociodemographic variables was calculated to understand the factors contributing to HIV positivity in each region.

RESULTS

In total, 143,211 pregnant women were recruited. HIV prevalence in AP was 0.30% (95% CI: 0.22 - 0.39) in 2019. The prevalence was 0.31%, 0.35% and 0.22% in Coastal Andhra, Rayalaseema and Uttar Andhra, respectively. HIV prevalence had significantly (P < 0.05) declined in all regions. The overall trend indicated that the HIV prevalence was higher among older pregnant women and in urban regions. However, recent trends consistently report HIV positivity among young and new pregnant mothers, illiterates, and rural regions.

CONCLUSION

The overall trend indicated that the HIV prevalence was higher among older pregnant women and in urban regions. However, recent trends consistently report HIV positivity among young and new pregnant mothers, illiterates, and rural regions. Identifying the contextual risk patterns associated with HIV transmission will further improve HIV preventive and management programs among the general population.

摘要

引言

为了实现有效的 HIV 管理，正在强调对国家以下各级别的局部风险进行分析并采取有针对性的干预措施。安得拉邦（AP）是印度 HIV 高发州，拥有第二多的 HIV 感染者（PWH），且州级 HIV 流行率持续下降。进一步深入研究该地区及各地区和区县级 HIV 流行率的趋势，将为了解次区域流行模式提供重要的信息。因此，本文分析了印度南部安得拉邦 2003 年至 2019 年期间参加产前检查（ANC）的孕妇的区域和区县级 HIV 流行率趋势。

方法

使用 2003 年至 2019 年期间在安得拉邦 HIV 哨点监测（HSS）中收集的孕妇 HIV 流行率数据进行趋势分析。将一致的监测点分为三个区域（沿海安得拉邦、雷亚勒姆和上安得拉邦），共 39 个监测点，包括 21 个农村和 18 个城市监测点。使用卡方趋势检验分析区域和区县级 HIV 流行率，并使用 QGIS 软件进行空间分析。对于最后三轮 HSS，根据社会人口学变量计算 HIV 流行率，以了解每个区域 HIV 阳性的原因。

结果

共招募了 143211 名孕妇。安得拉邦 2019 年 HIV 流行率为 0.30%（95%CI：0.22-0.39）。沿海安得拉邦、雷亚勒姆和上安得拉邦的流行率分别为 0.31%、0.35%和 0.22%。所有地区的 HIV 流行率均呈显著下降趋势（P<0.05）。整体趋势表明，HIV 流行率在年龄较大的孕妇和城市地区较高。然而，最近的趋势一致报告说，年轻和新的孕妇、文盲和农村地区的 HIV 阳性率较高。