Prevalence and correlates of active syphilis and HIV co-Infection among sexually active persons aged 15-59 years in Zambia: Results from the Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016.

Autor: Solomon H; Doctor of Public Health Program, School of Public Health, Boston University, Boston, MA, United States of America.; Ministry of Health Zambia, Ndeke House, Lusaka, Zambia.; National Health Research Authority, Lusaka, Zambia., Moraes AN; Ministry of Health Zambia, Ndeke House, Lusaka, Zambia.; Zambia National Public Health Institute, Lusaka, Zambia., Williams DB; Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America., Fotso AS; DPS University of the Witwatersrand, Johannesburg, South Africa.; ICAP at Columbia University, Mailman School of Public Health, Pretoria, South Africa., Duong YT; ICAP at Columbia University, Mailman School of Public Health, New York, NY, United States of America., Ndongmo CB; USAID Global Health Supply Chain Program, United States Agency for International Development, Arlington, Virginia, United States of America., Voetsch AC; Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America., Patel H; Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America., Lupoli K; Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America., McAuley JB; Rush University Medical Center, Chicago, Illinois, United States of America., Mulundu G; University Teaching Hospital, Lusaka, Zambia.; School of Medicine, University of Zambia, Lusaka, Zambia., Kasongo W; Tropical Disease Research Centre, Ndola, Zambia., Mulenga L; Ministry of Health Zambia, Ndeke House, Lusaka, Zambia.; University Teaching Hospital, Lusaka, Zambia.; School of Medicine, University of Zambia, Lusaka, Zambia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Jul 24; Vol. 15 (7), pp. e0236501. Date of Electronic Publication: 2020 Jul 24 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0236501
Abstrakt: Objectives: The main objectives of the study are to estimate HIV prevalence, active syphilis prevalence, and correlates of co-infection with HIV in Zambia, among recently sexually active individuals aged 15 to 59 years old.
Methods: We used data from the 2016 Zambia Population-based HIV Impact Assessment (ZAMPHIA), a national household survey that included biomarker testing for HIV and syphilis. Chembio DPP® Syphilis Screen and Confirm Assay was used to distinguish between active and older syphilis infections. This is the first time Chembio DPP® has been used in a national survey. Log-binominal modelling was utilized to understand the risk of acquiring HIV/active syphilis co-infection using select socio-demographic and sexual behavior variables. Multivariable analysis compared those with co-infection and those with no infection. All reported results account for the complex survey design and are weighted.
Results: A total of 19,114 individuals aged 15-59 years responded to the individual interview and had a valid syphilis and/or HIV test. The prevalence for those sexually active in the 12 months preceding ZAMPHIA 2016 was 3.5% and 13% for active syphilis and HIV, respectively. The prevalence of HIV/active syphilis co-infection was 1.5%. Factors associated with higher prevalence of co-infection versus no infection among females included, but were not limited to, those living in urban areas (adjusted prevalence ratio (aPR) = 3.0, 95% CI = 1.8, 4.8), those had sexual intercourse before age 15 years (aPR = 1.8, 95% CI = 1.1, 2.9), and those who had two or more sexual partners in the 12 months preceding the survey (aPR = 2.7, 95% CI = 1.6, 4.7).
Conclusion: These findings show high prevalence for both mono-infection with HIV and syphilis, as well as co-infection with HIV/active syphilis in Zambia. There is a need for better screening and partner services, particularly among those engaging in high-risk sexual behaviors (e.g., engaging in transactional sex).
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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