Title:
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HIV Incidence and Spatial Clustering in a Rural Area of Southern Mozambique
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Author:
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González, Raquel; Augusto, Orvalho; Munguambe, Khátia; Pierrat, Charlotte; Pedro, Elpidia N.; Sacoor, Charfudin; Lazzari, Elisa de; Aponte, John J.; Macete, Eusébio; Alonso, Pedro; Menéndez, Clara; Naniche, Denise
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Abstract:
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BACKGROUND: Monitoring the HIV epidemic in a defined population
is critical for planning treatment and preventive strategies.
This is especially important in sub-Saharan Africa, which
harbours the highest burden of the disease. OBJECTIVE: To
estimate HIV incidence in adults aged 18-47 years old and to
investigate spatial variations of HIV prevalence in Manhica, a
semi-rural area of southern Mozambique. METHODS: Two
cross-sectional community-based surveys were conducted in 2010
and 2012 to determine HIV prevalence. Individual participants
were randomly selected from the demographic surveillance system
in place in the area and voluntary HIV counselling and testing
was offered at the household level. HIV incidence was calculated
using prevalence estimates from the two sero-surveys. Each
participant's household was geocoded using a global information
system. The Spatial Scan Statistics programme was used to
identify areas with disproportionate excess in HIV prevalence.
RESULTS: A total of 1511 adults were tested. The estimated HIV
prevalence in the community was 39.9% in 2010 and 39.7% in 2012.
The overall HIV incidence was 3.6 new infections per 100
person-years at risk (PYAR) [95CI 1.56; 7.88], assuming stable
epidemic conditions, and tended to be higher in women (4.9/100
PYAR [95CI 1.74; 11.85]) than in men (3.2/PYAR [95CI 1.36;
9.92]). One cluster with significant excess HIV prevalence was
identified at the same geographic location in both surveys. This
cluster had an HIV prevalence of 79.0% in 2010 and 52.3% in
2012. CONCLUSIONS: The findings of these first
individually-randomised community-HIV sero-surveys conducted in
Mozambique reinforce the need to combine HIV incidence estimates
and research on micro geographical infection patterns to guide
and consolidate effective prevention strategies. |
Subject(s):
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-Infeccions per VIH -Epidemiologia -Moçambic -HIV infections -Epidemiology -Mozambique |
Rights:
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cc by (c) González et al., 2015
http://creativecommons.org/licenses/by/3.0/es/ |
Document type:
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Article Article - Published version |
Published by:
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Public Library of Science (PLoS)
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