Khadija I. Yahya-Malima|Bjørg Evjen Olsen|Mecky Matee|Knut Fýlkesnes
The silent HIV epidemic among pregnant women within rural Northern Tanzania
University of Bergen|University of Bergen|Muhimbili University of Health and Allied Sciences|University of Bergen
many national antenatal clinics anc based hiv surveillance systems subsaharan africa limited coverage remote rural sites weakness compromises adequate estimation monitoring development effective preventive care programmes address void rural manyara singida within northern tanzania conducted antenatal clinicbased sentinel surveillancewe consecutively enrolled 1377 counselled consenting pregnant women attending anc clinics first time current pregnancy study conducted six antenatal clinics within three divisions rural manyara singida regions 20032004 interviews conducted blood samples routine purposes collected tested antihiv igg antibody anonymously using bionor hiv1 2 assayamong enrollees 94 12961377 participated fully overall prevalence hiv 20 95ci 134297 highest hiv prevalence among women aged 1519 years rural remote rural populations odds hiv infection 43 95ci 1421277 times among women reporting one lifetime sexual partners compared one partner hiv infection associated history genital sores foul smelling discharge 68 95ci 2781666 age first pregnancy 25 times higher likelihood infection age 18 years versus later ageincluding rural remote sites part national anc routine surveillance crucial order discover imminent silent epidemics one described paper scaling hiv prevention efforts mandatory prevent imminent escalation hiv epidemic highly associated history sexually transmitted infections stis multiple sexual partners pregnancies younger age ignorance relevant knowledge low utilisation condoms underscores urgency largescale preventive efforts research capture wider representation risk factors general population priority enable customised hiv prevention efforts