Declining HIV prevalence and incidence in perinatal women in Harare, Zimbabwe

John W. Hargrove, Jean Hawes Humphrey, Agnes Mahomva, Brian G. Williams, Henry Chidawanyika, Kuda Mutasa, Edmore Marinda, Michael T. Mbizvo, Kusum J. Nathoo, Peter J. Iliff, Owen Mugurungi

Research output: Contribution to journalArticle

Abstract

Background: In several recent papers it has been suggested that HIV prevalence and incidence are declining in Zimbabwe as a result of changing sexual behavior. We provide further support for these suggestions, based on an analysis of more extensive, age-stratified, HIV prevalence data from 1990 to 2009 for perinatal women in Harare, as well as data on incidence and mortality. Methodology/principal findings: Pooled prevalence, incidence and mortality were fitted using a simple susceptible-infected (SI) model of HIV transmission; age-stratified prevalence data were fitted using double-logistic functions. We estimate that incidence peaked at 5.5% per year in 1991 declining to 1% per year in 2010. Prevalence peaked in 1998/9 [35.9% (CI95: 31.3-40.7)] and decreased by 67% to 11.9% (CI95: 10.1-13.8) in 2009. For women <20. y, 20-24. y, 25-29. y, 30-34. y and ≥ 35. y, prevalence peaked at 25.4%, 34.2%, 47.1%, 44.0% and 33.5% in 1993, 1996, 1997, 1998 and 1999, respectively, declining thereafter in every age group. Among women <25 y, prevalence peaked in 1994 at 28.8% declining thereafter by 69% to 8.9% (CI95: 6.8-11.5) in 2009. Conclusion/significance: HIV prevalence declined substantially among perinatal women in Harare after 1998 consequent upon a decline in incidence starting in the early 1990s. Our model suggests that this was primarily a result of changes in behavior which we attribute to a general increase in awareness of the dangers of AIDS and the ever more apparent increases in mortality.

Original languageEnglish (US)
Pages (from-to)88-94
Number of pages7
JournalEpidemics
Volume3
Issue number2
DOIs
StatePublished - Jun 2011

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Zimbabwe
HIV
Incidence
Mortality
Sexual Behavior
Acquired Immunodeficiency Syndrome
Age Groups

Keywords

  • Behavior change
  • HIV-1 incidence
  • HIV-1 prevalence
  • Zimbabwe

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Microbiology
  • Parasitology
  • Virology

Cite this

Hargrove, J. W., Humphrey, J. H., Mahomva, A., Williams, B. G., Chidawanyika, H., Mutasa, K., ... Mugurungi, O. (2011). Declining HIV prevalence and incidence in perinatal women in Harare, Zimbabwe. Epidemics, 3(2), 88-94. https://doi.org/10.1016/j.epidem.2011.02.004

Declining HIV prevalence and incidence in perinatal women in Harare, Zimbabwe. / Hargrove, John W.; Humphrey, Jean Hawes; Mahomva, Agnes; Williams, Brian G.; Chidawanyika, Henry; Mutasa, Kuda; Marinda, Edmore; Mbizvo, Michael T.; Nathoo, Kusum J.; Iliff, Peter J.; Mugurungi, Owen.

In: Epidemics, Vol. 3, No. 2, 06.2011, p. 88-94.

Research output: Contribution to journalArticle

Hargrove, JW, Humphrey, JH, Mahomva, A, Williams, BG, Chidawanyika, H, Mutasa, K, Marinda, E, Mbizvo, MT, Nathoo, KJ, Iliff, PJ & Mugurungi, O 2011, 'Declining HIV prevalence and incidence in perinatal women in Harare, Zimbabwe', Epidemics, vol. 3, no. 2, pp. 88-94. https://doi.org/10.1016/j.epidem.2011.02.004
Hargrove, John W. ; Humphrey, Jean Hawes ; Mahomva, Agnes ; Williams, Brian G. ; Chidawanyika, Henry ; Mutasa, Kuda ; Marinda, Edmore ; Mbizvo, Michael T. ; Nathoo, Kusum J. ; Iliff, Peter J. ; Mugurungi, Owen. / Declining HIV prevalence and incidence in perinatal women in Harare, Zimbabwe. In: Epidemics. 2011 ; Vol. 3, No. 2. pp. 88-94.
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abstract = "Background: In several recent papers it has been suggested that HIV prevalence and incidence are declining in Zimbabwe as a result of changing sexual behavior. We provide further support for these suggestions, based on an analysis of more extensive, age-stratified, HIV prevalence data from 1990 to 2009 for perinatal women in Harare, as well as data on incidence and mortality. Methodology/principal findings: Pooled prevalence, incidence and mortality were fitted using a simple susceptible-infected (SI) model of HIV transmission; age-stratified prevalence data were fitted using double-logistic functions. We estimate that incidence peaked at 5.5{\%} per year in 1991 declining to 1{\%} per year in 2010. Prevalence peaked in 1998/9 [35.9{\%} (CI95: 31.3-40.7)] and decreased by 67{\%} to 11.9{\%} (CI95: 10.1-13.8) in 2009. For women <20. y, 20-24. y, 25-29. y, 30-34. y and ≥ 35. y, prevalence peaked at 25.4{\%}, 34.2{\%}, 47.1{\%}, 44.0{\%} and 33.5{\%} in 1993, 1996, 1997, 1998 and 1999, respectively, declining thereafter in every age group. Among women <25 y, prevalence peaked in 1994 at 28.8{\%} declining thereafter by 69{\%} to 8.9{\%} (CI95: 6.8-11.5) in 2009. Conclusion/significance: HIV prevalence declined substantially among perinatal women in Harare after 1998 consequent upon a decline in incidence starting in the early 1990s. Our model suggests that this was primarily a result of changes in behavior which we attribute to a general increase in awareness of the dangers of AIDS and the ever more apparent increases in mortality.",
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