Saturday, January 30, 2016

Missed Opportunities to Offer HIV Tests to High-Risk Groups During General Practitioners' STI-Related Consultations

BACKGROUND:
The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa.

OBJECTIVE:
To establish the risk factors for incident HIV infection among antenatal clients aged 18-49 years attending public antenatal clinics in rural Eastern Cape, South Africa.

DESIGN:
This was an unmatched case-control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant.

RESULTS:
The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol.

CONCLUSIONS:
Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.

Below:  HIV testing in STI-related consultations among the two common high-risk groups at the Dutch general practice, 2008–2013



Full article at:   http://goo.gl/jNlE8a

  • 1Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands.
  • 2Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
  • 3Department of Sentinel Practices, NIVEL Primary Care Database, Utrecht, The Netherlands.
  • 4Stichting HIV Monitoring, Amsterdam, The Netherlands On behalf of the ATHENA National Observational HIV Cohort, Amsterdam, The Netherlands.
  • 5Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, Amsterdam, The Netherlands.
  • 6On behalf of the ATHENA National Observational HIV Cohort, Amsterdam, The Netherlands University Medical Center Utrecht, Utrecht, The Netherlands.
  • 7Department of General Practice, Division Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands STI AIDS Netherlands (Soa Aids Nederland), Amsterdam, The Netherlands. 
  •  2016 Jan 21;6(1):e009194. doi: 10.1136/bmjopen-2015-009194.


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