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HIV Incidence and Spatial Clustering in a Rural Area of Southern Mozambique.

González R, Augusto OJ, Munguambe K, Pierrat C, Pedro EN, Sacoor C, De Lazzari E, Aponte JJ, Macete E, Alonso PL, Menendez C, Naniche D - PLoS ONE (2015)

Bottom Line: The estimated HIV prevalence in the community was 39.9% in 2010 and 39.7% in 2012.One cluster with significant excess HIV prevalence was identified at the same geographic location in both surveys.This cluster had an HIV prevalence of 79.0% in 2010 and 52.3% in 2012.

View Article: PubMed Central - PubMed

Affiliation: ISGlobal, Barcelona Ctr. Int. Heath Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.

ABSTRACT

Background: Monitoring the HIV epidemic in a defined population is critical for planning treatment and preventive strategies. This is especially important in sub-Saharan Africa, which harbours the highest burden of the disease.

Objective: To estimate HIV incidence in adults aged 18-47 years old and to investigate spatial variations of HIV prevalence in Manhiça, a semi-rural area of southern Mozambique.

Methods: Two cross-sectional community-based surveys were conducted in 2010 and 2012 to determine HIV prevalence. Individual participants were randomly selected from the demographic surveillance system in place in the area and voluntary HIV counselling and testing was offered at the household level. HIV incidence was calculated using prevalence estimates from the two sero-surveys. Each participant's household was geocoded using a global information system. The Spatial Scan Statistics programme was used to identify areas with disproportionate excess in HIV prevalence.

Results: A total of 1511 adults were tested. The estimated HIV prevalence in the community was 39.9% in 2010 and 39.7% in 2012. The overall HIV incidence was 3.6 new infections per 100 person-years at risk (PYAR) [95CI 1.56; 7.88], assuming stable epidemic conditions, and tended to be higher in women (4.9/100 PYAR [95CI 1.74; 11.85]) than in men (3.2/PYAR [95CI 1.36; 9.92]). One cluster with significant excess HIV prevalence was identified at the same geographic location in both surveys. This cluster had an HIV prevalence of 79.0% in 2010 and 52.3% in 2012.

Conclusions: The findings of these first individually-randomised community-HIV sero-surveys conducted in Mozambique reinforce the need to combine HIV incidence estimates and research on micro geographical infection patterns to guide and consolidate effective prevention strategies.

No MeSH data available.


Related in: MedlinePlus

Age and sex specific HIV prevalence in 2010 and 2012.
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pone.0132053.g001: Age and sex specific HIV prevalence in 2010 and 2012.

Mentions: Detailed results of the 2010 sero-survey are described in Gonzalez et al.[12]. In 2012, 888 adults were approached and given an appointment card for a later mobile team visit, following the same methodology as the previous survey [12]. Of the 888 adults invited, 789 accepted to participate and were recruited with an acceptance rate of 88.9%, similar to that of 2010 of 86.1%[12]. There were no significant differences in sex, age or education of participants between surveys (Table 1). The community HIV prevalence in 2012 was 39.7% (95CI 36.0;43.5), similar to the 39.9% (95CI 35.9;43.8) observed in 2010[12]. The age and sex-specific HIV prevalence were also similar in both surveys (Fig 1). HIV prevalence was significantly lower in the 18–27 year age group for both men and women as compared to the older age groups in both survey years (p<0.001).


HIV Incidence and Spatial Clustering in a Rural Area of Southern Mozambique.

González R, Augusto OJ, Munguambe K, Pierrat C, Pedro EN, Sacoor C, De Lazzari E, Aponte JJ, Macete E, Alonso PL, Menendez C, Naniche D - PLoS ONE (2015)

Age and sex specific HIV prevalence in 2010 and 2012.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493140&req=5

pone.0132053.g001: Age and sex specific HIV prevalence in 2010 and 2012.
Mentions: Detailed results of the 2010 sero-survey are described in Gonzalez et al.[12]. In 2012, 888 adults were approached and given an appointment card for a later mobile team visit, following the same methodology as the previous survey [12]. Of the 888 adults invited, 789 accepted to participate and were recruited with an acceptance rate of 88.9%, similar to that of 2010 of 86.1%[12]. There were no significant differences in sex, age or education of participants between surveys (Table 1). The community HIV prevalence in 2012 was 39.7% (95CI 36.0;43.5), similar to the 39.9% (95CI 35.9;43.8) observed in 2010[12]. The age and sex-specific HIV prevalence were also similar in both surveys (Fig 1). HIV prevalence was significantly lower in the 18–27 year age group for both men and women as compared to the older age groups in both survey years (p<0.001).

Bottom Line: The estimated HIV prevalence in the community was 39.9% in 2010 and 39.7% in 2012.One cluster with significant excess HIV prevalence was identified at the same geographic location in both surveys.This cluster had an HIV prevalence of 79.0% in 2010 and 52.3% in 2012.

View Article: PubMed Central - PubMed

Affiliation: ISGlobal, Barcelona Ctr. Int. Heath Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.

ABSTRACT

Background: Monitoring the HIV epidemic in a defined population is critical for planning treatment and preventive strategies. This is especially important in sub-Saharan Africa, which harbours the highest burden of the disease.

Objective: To estimate HIV incidence in adults aged 18-47 years old and to investigate spatial variations of HIV prevalence in Manhiça, a semi-rural area of southern Mozambique.

Methods: Two cross-sectional community-based surveys were conducted in 2010 and 2012 to determine HIV prevalence. Individual participants were randomly selected from the demographic surveillance system in place in the area and voluntary HIV counselling and testing was offered at the household level. HIV incidence was calculated using prevalence estimates from the two sero-surveys. Each participant's household was geocoded using a global information system. The Spatial Scan Statistics programme was used to identify areas with disproportionate excess in HIV prevalence.

Results: A total of 1511 adults were tested. The estimated HIV prevalence in the community was 39.9% in 2010 and 39.7% in 2012. The overall HIV incidence was 3.6 new infections per 100 person-years at risk (PYAR) [95CI 1.56; 7.88], assuming stable epidemic conditions, and tended to be higher in women (4.9/100 PYAR [95CI 1.74; 11.85]) than in men (3.2/PYAR [95CI 1.36; 9.92]). One cluster with significant excess HIV prevalence was identified at the same geographic location in both surveys. This cluster had an HIV prevalence of 79.0% in 2010 and 52.3% in 2012.

Conclusions: The findings of these first individually-randomised community-HIV sero-surveys conducted in Mozambique reinforce the need to combine HIV incidence estimates and research on micro geographical infection patterns to guide and consolidate effective prevention strategies.

No MeSH data available.


Related in: MedlinePlus