HIV prevalence and sexual behaviour changes measured in an antenatal clinic setting in northern Tanzania

• Published in: Sexually transmitted infections 2006-08, Vol.82 (4), p.301-306
• Main Authors: Urassa, M, Kumogola, Y, Isingo, R, Mwaluko, G, Makelemo, B, Mugeye, K, Boerma, T, Calleja, T, Slaymaker, E, Zaba, B
• Format: Article
• Language: English
• Subjects: Adult; Age; ANC; antenatal care; Biological and medical sciences; Clinics; Condoms - statistics & numerical data; Consent; Data analysis; Data collection; Editing; Ethics; Feasibility Studies; Female; General aspects; HIV; HIV Infections - epidemiology; HIV Infections - psychology; HIV prevalence; Human immunodeficiency virus; Human infectious diseases. Experimental studies and models; Humans; Infections; Infectious diseases; Marriage; Medical sciences; Odds Ratio; PMTCT; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - psychology; Prenatal Care; Prevalence; prevention of mother to child transmission; Public Health; rapid protein reagin; RPR; Rural areas; Rural Health; Sexual Behavior; sexual behavioural; Sexual Partners; Sexually transmitted diseases; sexually transmitted infections; Sociodemographics; STD; STI; Studies; Surveillance; Syphilis; Tanzania; Tanzania - epidemiology; Trends; Urban Health; Variables; VCT; voluntary counselling and testing; Women
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sti.2005.016766

Objectives: To assess the feasibility of collecting sexual behaviour data during HIV surveillance in antenatal care (ANC) clinics, and to establish whether these data can provide information about the correlates of HIV infection in this population. Methods: Sexual behaviour surveys were conducted in the context of two HIV sentinel surveillance rounds in 11 ANC clinics in north west Tanzania between 2000 and 2002. Responses of individual women were anonymously linked to their HIV status. Three clinic catchment areas overlapped with a community based longitudinal study, which provided independent estimates of HIV prevalence and sexual behaviour. Changes between rounds and differentials between clinics were assessed and a two level logistic regression model used to identify behavioural and contextual correlates of HIV in 3689 women under 25 years of age. Results: Women attending clinics were willing to participate in the study. The sexual behaviour data obtained were internally consistent and tallied reasonably well with sexual behaviour data collected in the community overlapping the clinic catchment. Clear relations emerged between HIV infection and measures of sexual exposure: OR 1.20 (95% CL 1.12 to 1.28) for each year of premarital exposure and 1.09 (1.04 to 1.16) for each year after first marriage; background prevalence OR 1.15 (1.04 to 1.26) associated with each percentage point increase in background prevalence at the clinic; and certain partnership variables such as partner’s age OR 0.58 (0.45 to 0.76) if partner less than 10 years older. Conclusion: Conducting sexual behaviour surveys in the context of ANC clinics surveillance is feasible and yields useful data.