BACKGROUND: HIV prevalence time trends vary in sub-Saharan African countries. In the present study, we studied time trends and regional differences in the prevalence of HIV infection among women attending antenatal care clinics (ANC) in 7 sites located in 2 provinces in Cameroon. METHODOLOGY: As part of ANC, 16,626 women consented to HIV testing from 2000 to 2006. Sociodemographic and risk factor information was collected during the initial 3 years of the study. This information was aggregated within sites and used as site-level covariate in multilevel logistic regression analysis. RESULTS: HIV prevalence decreased significantly in women younger than 20 years from 13% in 2000 to 5% in 2006. Age-specific prevalence varied among the sites, with a peak prevalence occurring more often at a higher age in 2004-2006 versus 2000-2003, suggesting a reduction of HIV incidence over time. There was a substantial heterogeneity across sites in HIV prevalence, which was lower in sites where women had earlier sexual debut and were less well educated. CONCLUSIONS: ANC surveillance indicates a decreasing trend in HIV prevalence in the studied sites in Cameroon. Cultural differences might have accounted for the heterogeneity of HIV infection observed across sites, which call for tailored interventions.
BACKGROUND: HIV prevalence time trends vary in sub-Saharan African countries. In the present study, we studied time trends and regional differences in the prevalence of HIV infection among women attending antenatal care clinics (ANC) in 7 sites located in 2 provinces in Cameroon. METHODOLOGY: As part of ANC, 16,626 women consented to HIV testing from 2000 to 2006. Sociodemographic and risk factor information was collected during the initial 3 years of the study. This information was aggregated within sites and used as site-level covariate in multilevel logistic regression analysis. RESULTS: HIV prevalence decreased significantly in women younger than 20 years from 13% in 2000 to 5% in 2006. Age-specific prevalence varied among the sites, with a peak prevalence occurring more often at a higher age in 2004-2006 versus 2000-2003, suggesting a reduction of HIV incidence over time. There was a substantial heterogeneity across sites in HIV prevalence, which was lower in sites where women had earlier sexual debut and were less well educated. CONCLUSIONS: ANC surveillance indicates a decreasing trend in HIV prevalence in the studied sites in Cameroon. Cultural differences might have accounted for the heterogeneity of HIV infection observed across sites, which call for tailored interventions.
Authors: Alexander Kintu; Susan E Hankinson; Raji Balasubramanian; Karen Ertel; Elioda Tumwesigye; David R Bangsberg; Jessica E Haberer Journal: J Acquir Immune Defic Syndr Date: 2015-05-01 Impact factor: 3.731