Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.

<h4>Background</h4>A decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-populati...

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Autores principales:	Nkomba Kayeyi, Knut Fylkesnes, Charles Michelo, Mpundu Makasa, Ingvild Sandøy
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0df9f7e757a84f349d4a2d0f46a1fd1c
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spelling	oai:doaj.org-article:0df9f7e757a84f349d4a2d0f46a1fd1c2021-11-18T07:23:17ZDecline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.1932-620310.1371/journal.pone.0033652https://doaj.org/article/0df9f7e757a84f349d4a2d0f46a1fd1c2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22496759/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>A decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-population group differentials in HIV prevalence trends among men and women aged 15-24 years in Zambia.<h4>Design and methods</h4>We analysed ANC data for women aged 15-24 years from 22 sentinel sites consistently covered in the period 1994-2008, and HIV data for young men and women aged 15-24 years from the ZDHS 2001/2 and 2007. In addition, we systematically reviewed peer-reviewed articles that have reported findings on HIV prevalence and incidence among young people.<h4>Findings</h4>Overall trends of the ANC surveillance data indicated a substantial HIV prevalence decline among young women in both urban and rural areas. However, provincial declines differed substantially, i.e. between 10% and 68% among urban women, and from stability to 86% among rural women. Prevalence declines were steeper among those with the highest educational attainments than among the least educated. The ZDHS data indicated a significant reduction in prevalence between the two survey rounds among young women only. Provincial-level ZDHS changes were difficult to assess because the sample sizes were small. ANC-based trend patterns were consistent with those observed in PMTCT-based data (2002-2006), whereas population-based surveys in a selected urban community (1995-2003) suggested that the ANC-based data underestimated the prevalence declines in the general populations of both young both men and women.<h4>Conclusion</h4>The overall HIV prevalence declined substantially among young women in Zambia and this is interpreted as indicating a decline in HIV incidence. It is noteworthy that overall national trends masked substantial differences by place and by educational attainment, demonstrating critical limitations in the current focus on overall country-level trends in epidemiological reports.Nkomba KayeyiKnut FylkesnesCharles MicheloMpundu MakasaIngvild SandøyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e33652 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nkomba Kayeyi Knut Fylkesnes Charles Michelo Mpundu Makasa Ingvild Sandøy Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.
description	<h4>Background</h4>A decline in HIV incidence has been reported in Zambia and a number of other sub-Saharan countries. The trend of HIV prevalence among young people is a good marker of HIV incidence. In this study, different data sources are used to examine geographical and sub-population group differentials in HIV prevalence trends among men and women aged 15-24 years in Zambia.<h4>Design and methods</h4>We analysed ANC data for women aged 15-24 years from 22 sentinel sites consistently covered in the period 1994-2008, and HIV data for young men and women aged 15-24 years from the ZDHS 2001/2 and 2007. In addition, we systematically reviewed peer-reviewed articles that have reported findings on HIV prevalence and incidence among young people.<h4>Findings</h4>Overall trends of the ANC surveillance data indicated a substantial HIV prevalence decline among young women in both urban and rural areas. However, provincial declines differed substantially, i.e. between 10% and 68% among urban women, and from stability to 86% among rural women. Prevalence declines were steeper among those with the highest educational attainments than among the least educated. The ZDHS data indicated a significant reduction in prevalence between the two survey rounds among young women only. Provincial-level ZDHS changes were difficult to assess because the sample sizes were small. ANC-based trend patterns were consistent with those observed in PMTCT-based data (2002-2006), whereas population-based surveys in a selected urban community (1995-2003) suggested that the ANC-based data underestimated the prevalence declines in the general populations of both young both men and women.<h4>Conclusion</h4>The overall HIV prevalence declined substantially among young women in Zambia and this is interpreted as indicating a decline in HIV incidence. It is noteworthy that overall national trends masked substantial differences by place and by educational attainment, demonstrating critical limitations in the current focus on overall country-level trends in epidemiological reports.
format	article
author	Nkomba Kayeyi Knut Fylkesnes Charles Michelo Mpundu Makasa Ingvild Sandøy
author_facet	Nkomba Kayeyi Knut Fylkesnes Charles Michelo Mpundu Makasa Ingvild Sandøy
author_sort	Nkomba Kayeyi
title	Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.
title_short	Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.
title_full	Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.
title_fullStr	Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.
title_full_unstemmed	Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.
title_sort	decline in hiv prevalence among young women in zambia: national-level estimates of trends mask geographical and socio-demographic differences.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/0df9f7e757a84f349d4a2d0f46a1fd1c
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Decline in HIV prevalence among young women in Zambia: national-level estimates of trends mask geographical and socio-demographic differences.

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