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Recent HIV infection among pregnant women in the 2017 antenatal sentinel cross-sectional survey, South Africa: Assay-based incidence measurement
- Source :
- PLoS ONE, Vol 16, Iss 4, p e0249953 (2021), PLoS ONE
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- Introduction New HIV infection during pre-conception and pregnancy is a significant contributor of mother–to–child transmission of HIV in South Africa. This study estimated HIV incidence (defined as new infection within the last one year from the time of the survey which included both new infections occurred during pregnancy or just before pregnancy) among pregnant women and described the characteristics of recently infected pregnant women at national level. Methods Between 1 October and 15 November 2017, we conducted a national cross–sectional survey among pregnant women aged 15–49 years old attending antenatal care at 1,595 public facilities. Blood specimens were collected from pregnant women and tested for HIV in a centralised laboratory. Plasma viral load and Limiting Antigen Avidity Enzyme Immunosorbent Assay (LAg) tests were further performed on HIV positive specimens to differentiate between recent and long–term infections. Recent infection was defined as infection that occurred within one year from the date of collection of blood specimen for the survey. Data on age, age of partner, and marital status were collected through interviews. Women whose specimens were classified as recent by LAg assay and with viral loads >1,000 copies/mL were considered as recently infected. The calculated proportion of HIV positive women with recent infection was adjusted for assay–specific parameters to estimate annual incidence. Survey multinomial logistic regression was used to examine factors associated with being recently infected using HIV negative women as a reference group. Age–disparate relationship was defined as having a partner 5 or more years older. Results Of 10,049 HIV positive participants with LAg and viral load data, 1.4% (136) were identified as recently infected. The annual HIV incidence was 1.5% (95% confidence interval (CI): 1.2–1.7). In multivariable analyses, being single (adjusted odds ratio, aOR: 3.4, 95% CI: 1.8–6.2) or cohabiting (aOR: 3.8, 95% CI: 1.8–7.7), compared to being married as well as being in an age–disparate relationship among young women (aOR: 3.1, 95% CI: 2.0–4.7; reference group: young women (15–24years) whose partners were not 5 years or more older) were associated with higher odds of recent infection. Conclusions Compared to previous studies among pregnant women, the incidence estimated in this study was substantially lower. However, the UNAIDS target to reduce incidence by 75% by 2020 (which is equivalent to reducing incidence to
- Subjects :
- RNA viruses
0301 basic medicine
Epidemiology
Cross-sectional study
Maternal Health
HIV Infections
Pathology and Laboratory Medicine
South Africa
0302 clinical medicine
Immunodeficiency Viruses
Pregnancy
Odds Ratio
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Virus Testing
Multidisciplinary
Transmission (medicine)
Incidence
Incidence (epidemiology)
Age Factors
Obstetrics and Gynecology
Prenatal Care
Middle Aged
Viral Load
Sexual Partners
Medical Microbiology
HIV epidemiology
Viral Pathogens
Viruses
Infectious diseases
Marital status
Female
Pathogens
Viral load
Research Article
Adult
Medical conditions
Adolescent
Science
Viral diseases
Microbiology
Interviews as Topic
Young Adult
03 medical and health sciences
Antenatal Care
Diagnostic Medicine
Virology
Retroviruses
Humans
Microbial Pathogens
business.industry
Lentivirus
Organisms
HIV
Biology and Life Sciences
Odds ratio
medicine.disease
030112 virology
Confidence interval
Cross-Sectional Studies
Logistic Models
Women's Health
Pregnant Women
business
Viral Transmission and Infection
Demography
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 16
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....522ac30d094825389a60b7a8dd8bd4d6