High HIV-1 incidence in young women masked by stable overall seroprevalence among childbearing women in Kinshasa, Zaire: estimating incidence from serial seroprevalence data

V Batter, B Matela, M Nsuami, T Manzila, M Kamenga, F Behets, RW Ryder, WL Heyward, JM Karon, ME St.Louis

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    OBJECTIVE: To describe the dynamics of the HIV-1 epidemic in childbearing women in Kinshasa, Zaire, by estimating incidence from serial seroprevalence studies. METHODS: In 1986 and 1989, 5937 and 4623 pregnant women, respectively, were screened for HIV-1 in Kinshasa. We estimated age-specific incidence from two seroprevalence surveys by using a birth-year cohort analysis and adjusting for differences in mortality and fertility between HIV-1-infected and uninfected women. Mortality and fertility data were measured in a cohort of women recruited from the survey in 1986 and followed until 1989. RESULTS: While the overall HIV-1 seroprevalence changed little (5.8% in 1986 and 6.5% in 1989; P = 0.17), the prevalence increased in birth-year cohorts of women under 25 years of age in 1989 from 3.2 to 6.2% (P < 0.001), but decreased for women above 25 years of age from 6.9 to 6.7% (P = 0.7). In addition, new HIV infections between 1986 and 1989 were balanced by a higher mortality and lower fertility observed in HIV-infected women. After adjusting for these effects, we estimated an overall 3-year cumulative HIV-1 incidence of 2.8 per 100 uninfected women [95% confidence interval (CI), 1.4-4.2]. The highest incidence, 5.7 per 100 (95% CI, 3.5-8.0), was in women aged 20-24 years in 1989. CONCLUSION: Despite an overall relatively stable HIV-1 prevalence in childbearing women in Kinshasa between 1986 and 1989, approximately 40% of all HIV-1 infections detected in the 1989 survey occurred between 1986 and 1989, and 60% occurred in women under 25 years of age in 1989
    Original languageEnglish
    JournalAIDS
    Volume8
    Pages (from-to)811-817
    ISSN0269-9370
    Publication statusPublished - 1994

    Keywords

    • B780-tropical-medicine
    • Viral diseases
    • HIV-1
    • Seroprevalence
    • Women
    • Pregnancy
    • Incidence
    • Congo-Kinshasa
    • Kinshasa
    • Africa-Central

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