AEGiS-13IAC: Decline in HIV infection among young ANC attenders in Addis Ababa, Ethiopia: evidence from sentinel surveillance studies.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Decline in HIV infection among young ANC attenders in Addis Ababa, Ethiopia: evidence from sentinel surveillance studies.

Int Conf AIDS 2000 Jul 9-14; 13:36 (abstract no.. LbPeA7018)

Tsegaye A
Addis Ababa, Ethiopia. Fax: +251-1-765329, E-mail: aster@enarp.com.

BACKGROUND: Ethiopia has the third largest estimated HIV-1 infected population in the world. Until recently, HIV prevalence estimates obtained from studies in various Ethiopian population groups were regularly increasing year after year. Since 1995, we have established a sentinel surveillance system in Addis Ababa, the capital city to monitor the trends in HIV prevalence among ANC attenders. In the present study, we report trends in HIV prevalence over the four years period.

METHODS: Antenatal clinics (ANC included in the surveillance system were selected in areas of high (two clinics of the inner city) and low (two clinics of the outer city) HIV prevalence of the city. Unlinked anonymous HIV-1 testing was performed according to WHO guidelines. Serological tests were done using two ELISA's, and Western blot when ELISA results were discrepant. Antibodies to syphilis were tested using TPPA and RPR assays.

RESULTS: HIV-1 prevalence estimates among ANC attenders for 1995, 1996, 97, and 2000 were 21.2% (n=600), 17.8% (n= 1148), 16.8% (n=l194), and 14.9% (n=l121), respectively, suggesting a decline of HIV-1 prevalence levels. Between 1995 and 2000, the decline was particularly pronounced in young (<25 years) age groups (from 24.2% to 15.7%, p=0.007), and in inner city health centers from 21.2% to 15.8%, p=0.007). TPPA prevalence also dropped during the same time period (from 12.3% to 6.8%, p=0.001)

CONCLUSIONS: HIV and TPPA prevalence have declined between 1995 and 2000 among ANC attenders of Addis Ababa. This is an encouraging finding in light of the severity of the epidemic in the country. Additional studies are required to examine whether this decline is confirmed in other population groups, and to identify the determinants of the decline (change in sexual behaviours in young age groups?).

Keywords: AEGIS, HIV Infections, Prevalence, Sentinel Surveillance, HIV-1, HIV, Sex Behavior, HIV Seropositivity, HIV Seroprevalence, Syphilis, Disease Outbreaks, HIV Seronegativity, Ethiopia, Africa, immunology, AIDS
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