ArticleAIDS (London, England)2015
Do HIV prevalence trends in antenatal clinic surveillance represent trends in the general population in the antiretroviral therapy era? The case of Manicaland, East Zimbabwe.
Article in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Gender Norms and Structural Barriers to Use of HIV Prevention in Unmarried and Married Young Women in Manicaland, Zimbabwe: An HIV Prevention Cascade Analysis.Gates open research · 2024Article
- Article
- Difference in HIV prevalence by testing venue: results from population level survey in Uganda.AIDS care · 2021Article
- Effect of HIV Infection and Antiretroviral Treatment on Pregnancy Rates in the Western Cape Province of South Africa.The Journal of infectious diseases · 2020Article
- Combining national survey with facility-based HIV testing data to obtain more accurate estimate of HIV prevalence in districts in Uganda.BMC public health · 2020Article
- Targeting Pregnant Women for Malaria Surveillance.Trends in parasitology · 2019Review
- Using ante-natal clinic prevalence data to monitor temporal changes in malaria incidence in a humanitarian setting in the Democratic Republic of Congo.Malaria journal · 2018Article
- Documenting and explaining the HIV decline in east Zimbabwe: the Manicaland General Population Cohort.BMJ open · 2017Article
- Does nonlocal women's attendance at antenatal clinics distort HIV prevalence surveillance estimates in pregnant women in Zimbabwe?AIDS (London, England) · 2017Article
- Empirical validation of the UNAIDS Spectrum model for subnational HIV estimates: case-study of children and adults in Manicaland, Zimbabwe.AIDS (London, England) · 2017Article
- Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study.The lancet. HIV · 2016Article
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7 authors.
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Abstract
objectiveNational estimates of HIV trends in generalized epidemics rely on HIV prevalence data from antenatal clinic (ANC) surveillance. We investigate whether HIV prevalence trends in ANC data reflect trends in men and women in the general population during the scale-up of antiretroviral therapy (ART) in Manicaland, Zimbabwe.
methodsTrends in HIV prevalence in local ANC attendees and adults aged 15-49 years in towns, agricultural estates, and villages were compared using five rounds of parallel ANC (N = 1200) and general-population surveys (N = 10 000) and multivariable log-linear regression. Changes in the age pattern of HIV prevalence and the age distribution of ANC attendees were compared with those in the general population. Age-specific pregnancy prevalence rates were compared by HIV infection and ART status.
resultsCumulatively, from 1998-2000 to 2009-2011, HIV prevalence fell by 60.0% (95% confidence interval, 51.1-67.3%) in ANC surveillance data and by 34.3% (30.8-37.7%) in the general population. Most of the difference arose following the introduction of ART (2006-2011). The estates and villages reflected this overall pattern but HIV prevalence in the towns was lower at local ANCs than in the general population, largely because of attendance by pregnant women from outlying (lower prevalence) areas. The ageing of people living with HIV in the general population (52.4% aged >35 years, 2009-2011) was under-represented in the ANC data (12.6%) because of lower fertility in older and HIV-infected women.
conclusionAfter the introduction of ART in Manicaland, HIV prevalence declined more steeply in ANC surveillance data than in the general population. Models used for HIV estimates must reflect this change in bias.
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