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
- 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.
- BMJ Open. 2016 Jan 21;6(1):e009194. doi: 10.1136/bmjopen-2015-009194.
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