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Risk behaviors and patterns of HIV seroprevalence in countries with generalized epidemics: Results from the Demographic and Health Surveys

Vinod Mishra, PhD, Rathavuth Hong, DrPH, and Shane Khan, MPH. MEASURE DHS, ORC Macro, 11785 Beltsville Drive, Calverton, MD 20705, 301-572-0220, vinod.mishra@orcmacro.com

Background: Reliable data on HIV seroprevalence and risk factors are essential for an effective response to the epidemic and its consequences. This study describes the methods used in the Demographic and Health Surveys to collect nationally-representative data on HIV seroprevalence in countries with generalized epidemics and discusses the risk behaviors and patterns of HIV seroprevalence.

Methods: During 20012005, HIV testing was conducted among nationally-representative samples of adult women and men in Mali, Zambia, Dominican Republic, Kenya, Ghana, Burkina Faso, Tanzania, Cameroon, Senegal, Guinea, Uganda, Lesotho, and Malawi, using dried blood spot samples (venous blood in Zambia and Uganda and oral mucosal transudate in Dominican Republic). Results are presented by age, sex, urban/rural residence, education, marital union, wealth status, geographic region, and selected risk behaviors, including multiple sex partners, higher-risk sex, condom use, male circumcision, and reported STIs.

Results: Despite large HIV prevalence differences among the surveys (124%), fairly consistent patterns of HIV infection are observed by age, sex, and urban/rural residence, with considerably higher rates in urban areas and for women, especially at younger ages. Adults in wealthier households, in polygamous unions, being widowed/divorced/separated, having multiple sex partners, and having reported STIs had higher HIV rates than other adults. No consistent relationship between male circumcision and HIV risk was observed in most countries.

Conclusions: Population-based surveys can provide reliable, national and regional direct estimates of HIV seroprevalence and associated risk factors. These data can help identify higher-risk groups and behaviors, and enhance surveillance systems in generalized epidemics.

Learning Objectives:

Keywords: HIV/AIDS, Epidemiology

Presenting author's disclosure statement:

Not Answered

HIV/AIDS: A Focus On Africa

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA