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Open Access Research article

Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania

Yusufu Kumogola1, Emma Slaymaker2*, Basia Zaba12, Julius Mngara1, Raphael Isingo1, John Changalucha1, Patrick Mwidunda3, Daniel Kimaro4 and Mark Urassa1

Author Affiliations

1 National Institute for Medical Research, PO Box 1462, Mwanza, Tanzania

2 Population Studies Department, London School of Hygiene and Tropical Medicine, 49-51 Bedford Square, London, WC1B 3DP, UK

3 District Health Department for Magu, Magu District Council, Magu, Tanzania

4 City Health Department, Mwanza City Council, Mwanza, Tanzania

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BMC Public Health 2010, 10:553  doi:10.1186/1471-2458-10-553

Published: 13 September 2010

Abstract

Background

Sentinel surveillance for HIV in ante-natal clinics (ANC) remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC) in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania. HIV prevalence from ANC surveys in 2000 and 2002 was 10.5% and 10.8% respectively. In previous rounds urban residence, residential mobility, the length of time sexually active before marriage, time since marriage and age of the partner were associated with HIV infection.

Methods

A third round of HIV sentinel surveillance was conducted at ante-natal clinics in Mwanza region, Tanzania during 2006. We interviewed women attending 27 ante-natal clinics. In 15 clinics we also anonymously tested women for syphilis and HIV infection and linked these results to the questionnaire data.

Results

HIV prevalence was 7.6% overall in 2006 and 7.4% at the 11 clinics used in previous rounds. Geographical variations in HIV prevalence, apparent in previous rounds, have largely disappeared but syphilis prevalence is still higher in rural clinics. HIV prevalence has declined in urban clinics and is stable in rural clinics. The correlates of HIV infection have changed over time. In this round older age, lower gravidity, remarriage, duration of marriage, sexual activity before marriage, long interval between last birth and pregnancy and child death were all associated with infection.

Conclusions

HIV prevalence trends concur with results from a community-based cohort in the region. Correlates of HIV infection have also changed and more proximate, individual level factors are now more important, in line with the changing epidemiology of infection in this population.