Comparison of HIV Prevalence Estimates From Sentinel Surveillance and a National Population-Based Survey in Uganda, 2004-2005

Authors:
  • WKWilford Kirungi
    Wilford Kirungi
  • AOAlex Opio
    Alex Opio
  • LMLivia Montana
    Livia Montana
  • VMVinod Mishra
    Vinod Mishra
  • EMElizabeth Madraa
    Elizabeth Madraa
  • BBBenon Biryahwaho
    Benon Biryahwaho
  • JMJonathan Mermin
    Jonathan Mermin
  • RBRebecca Bunnell
    Rebecca Bunnell
  • ACAnne Cross
    Anne Cross
  • WHWolfgang Hladik
    Wolfgang Hladik
  • WMWillie McFarland
    Willie McFarland
Publisher website
Google Scholar
Abstract
HIV programs in generalized epidemics have traditionally relied on antenatal clinic (ANC) sentinel surveillance data to guide prevention and to model epidemic trends. ANC data, however, come from a subset of the population, and their representativeness of the population has been debated. Data from a national population-based Uganda HIV/AIDS Sero-Behavioral Survey (UHSBS) were compared with those from ANC sentinel surveillance. Using geographic information system, UHSBS clusters within a 30 km radius of the ANC sites were mapped. Estimates of HIV prevalence from ANC surveillance were compared with those from UHSBS. The ANC-based HIV prevalence, 6.0% [confidence interval (CI) 5.5% to 6.5%], was similar to that from UHSBS, 5.9% (CI 5.4% to 6.4%). The ANC-based estimate correlated with that of UHSBS catchment area women who were pregnant and those who had given birth in the 2 years preceding the survey. ANC data overestimated prevalence in the 15-year to 19-year age group, were similar to UHSBS for ages 20-29 years, and underestimated prevalence in older respondents. ANC data underestimated HIV prevalence among women (6.0% vs. 7.4%; CI 6.6% to 8.2%) and urban women (7.6% vs. 12.7%) but was similar for rural women (5.3% vs. 4.9%). ANC-based surveillance remains an important tool for monitoring HIV/AIDS programs. ANC and UHSBS data were similar overall and for 15-year to 29-year olds, women who were pregnant, and women who had a birth in the 2 years before the survey. ANC estimates were lower in those > or = 30 years and in urban areas. Periodic serosurveys to adjust ANC-based estimates are needed.

This publication has 10 references indexed in Scilit: