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. 2010 Sep 13:10:553.
doi: 10.1186/1471-2458-10-553.

Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania

Yusufu Kumogola  1 , Emma Slaymaker, Basia Zaba, Julius Mngara, Raphael Isingo, John Changalucha, Patrick Mwidunda, Daniel Kimaro, Mark Urassa
Affiliations

Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania

Yusufu Kumogola et al. BMC Public Health. .

Abstract

Background: Sentinel surveillance for HIV in ante-natal clinics (ANC) remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC) in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania. HIV prevalence from ANC surveys in 2000 and 2002 was 10.5% and 10.8% respectively. In previous rounds urban residence, residential mobility, the length of time sexually active before marriage, time since marriage and age of the partner were associated with HIV infection.

Methods: A third round of HIV sentinel surveillance was conducted at ante-natal clinics in Mwanza region, Tanzania during 2006. We interviewed women attending 27 ante-natal clinics. In 15 clinics we also anonymously tested women for syphilis and HIV infection and linked these results to the questionnaire data.

Results: HIV prevalence was 7.6% overall in 2006 and 7.4% at the 11 clinics used in previous rounds. Geographical variations in HIV prevalence, apparent in previous rounds, have largely disappeared but syphilis prevalence is still higher in rural clinics. HIV prevalence has declined in urban clinics and is stable in rural clinics. The correlates of HIV infection have changed over time. In this round older age, lower gravidity, remarriage, duration of marriage, sexual activity before marriage, long interval between last birth and pregnancy and child death were all associated with infection.

Conclusions: HIV prevalence trends concur with results from a community-based cohort in the region. Correlates of HIV infection have also changed and more proximate, individual level factors are now more important, in line with the changing epidemiology of infection in this population.

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Figures

Figure 1
Figure 1
Location of 2006 study clinics and HIV prevalence at clinics where we collected HIV status.
Figure 2
Figure 2
Trend in HIV prevalence over time by location of clinic (data from the 11 clinics that participated in all rounds).
Figure 3
Figure 3
Syphilis prevalence at study clinics in 2006
Figure 4
Figure 4
Years spent single and sexually active before marriage by survey round
See this image and copyright information in PMC

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