Comparison of programmatic data from antenatal clinics with population-based HIV prevalence estimates in the era of universal test and treat in western Kenya.

Autor: Ambia J; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Romero-Prieto JE; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Kwaro D; Kenya Medical Research Institute - Center for Global Health Research, Kisumu, Kenya., Risher K; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom., Khagayi S; Kenya Medical Research Institute - Center for Global Health Research, Kisumu, Kenya., Calvert C; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom., Obor D; Kenya Medical Research Institute - Center for Global Health Research, Kisumu, Kenya., Tlhajoane M; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Odongo F; Kenya Medical Research Institute - Center for Global Health Research, Kisumu, Kenya., Marston M; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Slaymaker E; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Rice B; MeSH Consortium, Department of Public Health Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom., Kabudula CW; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Eaton JW; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom., Reniers G; Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Jun 26; Vol. 18 (6), pp. e0287626. Date of Electronic Publication: 2023 Jun 26 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0287626
Abstrakt: Objective: To compare HIV prevalence estimates from routine programme data in antenatal care (ANC) clinics in western Kenya with HIV prevalence estimates in a general population sample in the era of universal test and treat (UTT).
Methods: The study was conducted in the area covered by the Siaya Health Demographic Surveillance System (Siaya HDSS) in western Kenya and used data from ANC clinics and the general population. ANC data (n = 1,724) were collected in 2018 from 13 clinics located within the HDSS. The general population was a random sample of women of reproductive age (15-49) who reside in the Siaya HDSS and participated in an HIV sero-prevalence survey in 2018 (n = 2,019). Total and age-specific HIV prevalence estimates were produced from both datasets and demographic decomposition methods were used to quantify the contribution of the differences in age distributions and age-specific HIV prevalence to the total HIV prevalence estimates.
Results: Total HIV prevalence was 18.0% (95% CI 16.3-19.9%) in the ANC population compared with 18.4% (95% CI 16.8-20.2%) in the general population sample. At most ages, HIV prevalence was higher in the ANC population than in the general population. The age distribution of the ANC population was younger than that of the general population, and because HIV prevalence increases with age, this reduced the total HIV prevalence among ANC attendees relative to prevalence standardised to the general population age distribution.
Conclusion: In the era of UTT, total HIV prevalence among ANC attendees and the general population were comparable, but age-specific HIV prevalence was higher in the ANC population in most age groups. The expansion of treatment may have led to changes in both the fertility of women living with HIV and their use of ANC services, and our results lend support to the assertion that the relationship between ANC and general population HIV prevalence estimates are highly dynamic.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Ambia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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