Predictive value of latex agglutination test in serological screening for Toxoplasma gondii

The predictive value of commercial latex agglutination kit (Toxo-Screen DA, bioMerieux) was assessed for use as screening test for Toxoplasma IgG antibody. The sensivity and specificity were also compared with those of the reference standard Sabin-Feldman dye test. Five hundred serum samples were collected from 200 blood donors and 100 each from pregnant women, kidney recipients and HIV infected persons. Eighty (16.0%) out of 500 subjects were positive for Toxoplama IgG antibody by Toxo-Screen DA (bioMerieux) compared with 57 (11.4%) by Sabin-Feldman dye test. The sensivity and specificity of Toxo-Screen DA (bioMerieux) were 100% and 94.8 % respectively which were similar to previous reports from the area of high prevalence of Toxoplasma infection. In present study the positive predictive value of Toxo-Screen DA (bioMerieux) was only 71.3%. The latex agglutination test should be considered as a screening test for Toxoplasma antibody, especially by small laboratories in remote area due to its availability, simplicity, sensitivity and specificity. However, because of its moderate positive predictive value, the test should be used with caution in screening immunocompromised patients and pregnant women living in areas with low prevalence of Toxoplasma infection. Since the number of false seropositive cases would be relatively higher than in a highly prevalent area, confirmation by the dye test would be needed.     

Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique

Toxoplasmosis, a protozoan disease, causes severe disease in fetuses during pregnancy and deadly encephalitis in HIV patients. There are several studies on its seroprevalence around the world, but studies focusing on African countries are limited in number and mostly anecdotal. We studied two groups of samples from Mozambique by ELISA, using serum samples from 150 pregnant women and six Cerebrospinal fluid (CSF) samples from AIDS patients with encephalitis. HIV status was confirmed, and CD4 blood counts were obtained from HIV-positive pregnant women. IgG seroprevalence of the group as a whole was 18.7% (28/150), with a higher prevalence in HIV-positive individuals compared to those who were HIV-negative (31.3%, [18/58] vs. 10.9%, [10/92]) patients. These data may be biased due to cumulative effects of exposition affecting disease prevalence. If corrected, this data may indicate an interaction of HIV and T. gondii. Prevalence of both diseases increases with age, but this is more clearly seen for toxoplasmosis (p < 0.005) than HIV infection, possibly explained by higher transmission of HIV after childhood. In HIV patients suffering from encephalitis, CSF serology showed that 33% of specific IgG CSF had a high avidity, which was in accordance with the data from the group of pregnant women. Lower prevalence rates of both infections in older groups could be explained by more deaths in the infected groups, resulting in an artificially lower prevalence. Using CD4 counts as a marker of time of HIV infection, and correcting for age, patients with contact with T. gondii had fewer CD4 cells, suggesting prolonged HIV disease or other causes. Toxoplasma IgG prevalence is higher in HIV+ groups, which could be ascribed to HIV- and T. gondii-associated risk factors, such as exposure to higher and more diverse social contacts. The low incidence of Toxoplasma IgG in younger age groups shows that transmission could be related to better access to cyst-containing meat in adulthood, as environmental transmission due to oocysts is usually blamed for higher incidence in children. Taken together, these data support the urgent need of research in toxoplasmosis in Africa, especially in the presence of HIV epidemics.     

杭州市高危人群弓形虫感染血清流行病学调查

目的了解杭州市高危人群弓形虫感染和弓形虫病防治知识知晓情况。方法采用ELISA方法检测杭州市100例HIV/AIDS患者、100例恶性肿瘤患者、100例孕妇和100例健康对照者血清抗弓形虫抗体,对全部调查对象进行弓形虫病防治知识问卷调查。结果 HIV/AIDS、恶性肿瘤患者和孕妇血清抗弓形虫抗体阳性率分别为31%、30%和21%,均显著高于健康对照者的5%(χ~2=14.68,13.96和7.56,P均0.01)。孕妇对弓形虫病防治知识的知晓率整体较高,健康对照者对弓形虫病防治知识的知晓率整体较低;调查对象对"你知道弓形虫感染的危害吗?"、"你知道生食或食用未煮熟的肉类会感染弓形虫吗?"和"你知道接触被污染的土壤会感染弓形虫吗?"等问题的知晓率较低。结论杭州市HIV/AIDS、恶性肿瘤患者和孕妇等高危人群弓形虫感染率较高,且对部分弓形虫病防治知识知晓率较低。有必要加强对高危重点人群的弓形虫病防治知识健康教育,有效预防和控制弓形虫感染。     

Human herpesvirus 8 infection and Kaposi's sarcoma among human immunodeficiency virus-infected and -uninfected women

Little is known about the epidemiology of human herpesvirus 8 (HHV-8) infections among women. A cross-sectional study was conducted of HHV-8 infection among human immunodeficiency virus (HIV)-infected and high-risk HIV-uninfected women. Serological tests with noninduced (latent) and induced (lytic) HHV-8 antigens were used to detect infection among 2483 participants of a multisite cohort. Reactivity to latent antigen was present in 4.1% and to induced antigens in 12.0% of women. Seven of 8 women who reported Kaposi's sarcoma had HHV-8 antibodies. Among HIV-positive women, HHV-8 infection was associated with use of crack, cocaine, or heroin (76% vs. 65%; P<.001), past syphilis (29% vs. 20%; P<.001), an injection drug-using male sex partner (61% vs. 53%; P=.014), black race (P=.010), and enrollment site (P=.015). In multivariate analysis, HIV infection, older age, past syphilis, black race, and enrollment site were independently associated with HHV-8 infection. In this cohort of North American women, HHV-8 infection was associated with HIV infection, drug use, and risky sexual behavior.     

Risk factors for HIV infection among women in Carletonville, South Africa: migration, demography and sexually transmitted diseases

We investigate the prevalence of, and risk factors for, HIV infection among women in an urban South African setting. A random sample of 834 women was recruited into a community-based cross-sectional study. HIV prevalence was 37.1% with higher prevalence among migrant women (46.0%) than non-migrant women (34.7%), (odds ratio [OR]=1.61, 95% confidence interval [CI]: 1.11-2.31). The highest HIV prevalence (50.9%) was between ages 26 and 35 years. Having two or more lifetime partners increased the risk of HIV infection (OR=4.88, 95% CI: 3.01-7.89). Migration, age, marital status, alcohol use, syphilis and gonorrhoea were independently associated with HIV infection. Migration increases the risk of HIV infection. Provision of services to treat sexually transmitted diseases and educational empowerment programmes that will promote safer sex among migrant women are urgently needed.     

无锡地区不良妊娠结局妇女弓形虫感染及弓形虫病知识知晓率调查

目的 调查无锡地区不良妊娠结局妇女弓形虫感染情况及弓形虫病相关知识知晓率。 方法 以2011年1月至2015年12月无锡市217例不良妊娠结局妇女作为研究对象（试验组）,以250例正常妊娠妇女作为对照。采用ELISA法检测并比较试验组和对照组血清抗弓形虫抗体阳性率。采用自行设计的问卷对试验组和对照组妇女进行问卷调查,比较两组弓形虫病相关知识知晓率。 结果 试验组妇女血清抗弓形虫抗体阳性率为30.88%,显著高于正常妊娠妇女的8.80%（[χ2]= 36.70,P < 0.01）;抗弓形虫IgG和IgM抗体阳性率分别为20.74%和10.14%,显著高于对照组的6.00%和2.80%（[χ2]= 22.53和10.74,P 均 < 0.01）。此外,以胎停、自然流产、早产和出生缺陷为妊娠结局的妇女血清抗弓形虫抗体阳性率及血清抗弓形虫IgG和IgM抗体阳性率均显著高于正常妊娠妇女（P均< 0.05）。试验组妇女对“你听说过弓形虫或弓形虫病吗？” （P < 0.01）、“你知道养宠物猫和犬会感染弓形虫吗？”（P < 0.05）和“你知道孕期需要进行弓形虫感染检查吗？”（P < 0.01）等3道问题的知晓率显著低于对照组,而两组妇女对“你知道吃火锅会感染弓形虫吗？”、“你知道家中砧板生熟不分可能会导致弓形虫感染吗？”、“你知道孕妇感染弓形虫会传给胎儿吗？”、“你知道孕期弓形虫感染会导致流产、死胎、胎儿畸形等不良妊娠结局吗？”和“你知道孕妇感染弓形虫需要治疗吗？”等问题的知晓率差异无统计学意义（P 均> 0.05）。结论 无锡市地区不良妊娠妇女弓形虫感染率显著高于正常妊娠妇女。考虑到孕妇感染弓形虫的危害以及孕妇对弓形虫病相关知识知晓率较低的现状,应进一步加大弓形虫病相关知识宣传和健康教育力度,特别是对备孕妇女开展有针对性的弓形虫病健康教育,以降低孕妇弓形虫感染率、提高优生优育水平。     

HIV infection among pregnant women in Bobo-Dioulasso, Burkina Faso: comparison of voluntary and blinded seroprevalence estimates

The objective of our study was to estimate the prevalence of HIV infection among pregnant women in Bobo-Dioulasso (Burkina Faso) according to 2 survey methods. Unlinked anonymous HIV screening was performed among women attending 2 antenatal clinics. Voluntary and confidential HIV counselling and testing were offered to women attending 2 other antenatal clinics in the same time period, September-October 1996. Voluntary HIV testing was performed in the context of a clinical trial on mother-to-child transmission of HIV (ANRS 049 clinical trial) with an acceptance rate of HIV testing of 93%. The first survey recruited 200 women and the second, 424. The mean age (24.6 years vs 24.8 years) and the mean number of pregnancies (3.1 vs 3.3) of women were comparable, in the 2 studies (P=0.69 and P=0.26, respectively). Prevalence of HIV infection in the blinded survey was estimated at 10.0% (95% confidence interval (CI): 6.4-15.2), while it was 9.4% (95% CI: 6.9-12.7) in the voluntary HIV screening programme. These 2 estimates were not statistically different (P=0.82). In the voluntary screening study, the prevalence of HIV infection was significantly different between age groups 15-24 years and 25-49 years (13.9% vs 4.5%, P < 0.001). In the age group 25-49 years, the prevalence of HIV infection estimated in the blinded study and in the voluntary screening study were significantly different (10.5% vs 4.5%, P=0.04) suggesting a potential participation bias among pregnant women of older age in the voluntary, confidential HIV screening group. In conclusion, for the purpose of HIV surveillance, the most reliable method for HIV prevalence remains the unlinked, anonymous testing.     

Trichomonas vaginalis infection and human immunodeficiency virus acquisition in African women

BACKGROUND: Trichomoniasis vaginalis is the most common nonviral sexually transmitted infection (STI) worldwide, with a particularly high prevalence in regions of human immunodeficiency virus (HIV) endemicity. However, its impact as a cofactor for HIV acquisition is poorly understood. METHODS: Samples from 213 women who experienced HIV seroconversion (cases) during a longitudinal study involving 4450 women in Uganda and Zimbabwe were matched with samples from HIV-uninfected women (controls). All samples underwent polymerase chain reaction (PCR) analysis for Trichomonas vaginalis DNA. For cases, analyzed samples were from the visit in which HIV seroconversion was detected and the visit preceding detection of seroconversion; for controls, one analyzed sample was from the visit matched by follow-up duration to the cases' seroconversion visit, and the other sample was from the visit immediately preceding the matched visit. RESULTS: The prevalence of T. vaginalis infection before HIV infection was 11.3% in cases and 4.5% in controls (P = .002). In multivariable analysis controlling for hormonal contraception, other STIs, behavioral, and demographic factors, the adjusted odds ratio for HIV acquisition was 2.74 (95% confidence interval, 1.25-6.00) for T. vaginalis-positive cases. The presence of behavioral risk factors for HIV infection, study recruitment from a referral population at high-risk for HIV, primary sex partner-associated risk for HIV infection, and herpes simplex virus type 2 seropositivity were also predictive of incident HIV infection. CONCLUSIONS: T. vaginalis infection is strongly associated with an increased risk for HIV infection in this general population of African women. Given the high prevalence of T. vaginalis infection in HIV-endemic areas, T. vaginalis control may have a substantial impact on preventing HIV acquisition among women.     

Human immunodeficiency virus and malaria in a representative sample of childbearing women in Kigali, Rwanda

In 1986-1987 a consecutive sample of 3702 women presenting to prenatal and pediatric clinics at the only hospital in Kigali, Rwanda, was screened for human immunodeficiency virus (HIV) and malaria infection. The prevalence of HIV antibodies was 29%, and that of malaria parasites was 9%. HIV antibodies were more prevalent in women from the urban center than in those from the outskirts (31% vs. 20%, P less than .001), and malaria parasites showed the opposite prevalence pattern (8% vs. 15%, P less than .001); after stratifying by location, there was no association between HIV and the presence or degree of malaria parasitemia. HIV prevalence was 45% in women who had received a blood transfusion between 1980-1985 (before screening of donated blood began), and 28% among the great majority (94%) who had never been transfused. HIV prevalence was 44% in single mothers. 34% in women in common law unions, and 20% in those in legal marriages. These high rates of infection in the general population of Kigali highlight the need to develop effective programs for preventing further spread of sexually transmitted HIV.     

HIV infection among youth in a South African mining town is associated with herpes simplex virus-2 seropositivity and sexual behaviour

OBJECTIVES: To determine the seroprevalence of HIV and herpes simplex virus-2 (HSV-2) by age and gender among young people aged 14--24 years in a South African town and to identify risk factors for HIV infection. DESIGN: A community-based, cross-sectional study was conducted on a random sample of men (n = 723) and women (n = 784) living in a township in the Carletonville district of South Africa. METHODS: Potential demographic and behavioural risk factors associated with HIV were recorded by questionnaire and biological tests were performed on serum and urine. Data analysis was performed using multivariate logistic regression. RESULTS: Among men and women the prevalence of HIV infection was 9.4 and 34.4%, respectively, and of positive HSV-2 serology was 17.0 and 53.3%, respectively. Among 24-year-old women the prevalence of HIV was 66.7% [95% confidence interval (CI), 54.6--77.3%]. HSV-2 seropositivity was a strong independent risk factor for HIV infection with odds ratios of 5.3 (95% CI, 2.7--10.3) for men and 8.4 (95% CI, 4.9--14.2) for women. There was no independent effect of age at first sex or serological markers of other sexually transmitted infections on HIV infection. CONCLUSIONS: HIV infection among young women increases rapidly after the onset of sexual activity and reaches extremely high levels by 24 years of age. These findings suggest that rates of HIV transmission from men to women are high and that HSV-2 plays a major role in the spread of HIV in this population.     

南京市特殊人群弓形虫感染调查

目的 了解南京市特殊人群弓形虫感染情况,为特殊人群弓形虫病防控提供参考依据。方法 2015年9-11月选取南京市HIV/AIDS病人、肿瘤患者、孕妇、畜禽养殖及畜产品加工人员等4类特殊人群作为调查对象,采用酶联免疫吸附试验检测血清抗弓形虫特异性抗体。结果 南京市4类特殊人群弓形虫总感染率为10.2%,其中IgG抗体阳性率为10.2%,IgM抗体阳性率为0.5%。HIV/AIDS患者、畜禽养殖及畜产品加工人员、孕妇和肿瘤病人抗弓形虫抗体阳性率分别为12.2%、11.3%、4.0%和13.0%,差异无统计学意义（[χ2] = 5.668,P = 0.130）。男性调查对象抗弓形虫抗体阳性率高于女性（15.3% vs. 5.8%;[χ2] = 10.213,P = 0.001）,不同年龄组（[χ2] = 9.501,P = 0.023）、不同文化程度（[χ2] = 9.850,P = 0.043）和不同职业调查对象抗弓形虫抗体阳性率差异无统计学意义（[χ2] = 8.983,P = 0.062）。结论 南京市特殊人群弓形虫感染率较高,后续工作应有针对性地加强对特殊人群的健康教育干预。     

HIV 阳性人群合并弓形虫感染现况调查

目的了解我国农村地区HIV阳性人群合并弓形虫感染现状,以及合并感染与CD4+T淋巴细胞的关系。方法按1:1匹配的方式,在现场招募HIV阳性感染者和HIV阴性对照624人作为研究对象,采集其外周血样本,采用ELISA法检测弓形虫抗体,并检测其体内CD4+T淋巴细胞水平。结果共对604人同时进行了弓形虫抗体和CD4+T淋巴细胞水平检测,HIV阳性人群弓形虫抗体阳性率为1.32%,阴性对照人群弓形虫抗体阳性率为0.33%,两者差异无统计学意义(P0.05)。HIV阳性感染者中,合并和未合并弓形虫感染者体内CD4+T淋巴细胞水平分别为(446.75±177.25)个/μl和(413.55±243.37)个/μl,两者差异无统计学意义。结论当地一般人群和HIV阳性人群弓形虫感染率均较低,弓形虫感染与HIV阳性人群体内CD4+T淋巴细胞水平之间的关系有待进一步研究。     

Study of bias in antenatal clinic HIV-1 surveillance data in a high contraceptive prevalence population in sub-Saharan Africa

OBJECTIVE: To describe patterns, sources and consequences of bias in antenatal clinic (ANC) HIV prevalence estimates in a high contraceptive prevalence population. BACKGROUND: HIV surveillance in Africa relies on data from pregnant women attending ANCs. HIV estimates from pregnant women understate female infection levels in low income, high fertility populations. Bias in high contraceptive use, delayed sexual debut populations remains undescribed. DESIGN AND METHOD: Comparison of parallel cross-sectional population and antenatal survey data from rural Zimbabwe, where 60% of women are recent contraceptive users. RESULTS: HIV prevalence in recently pregnant women (25.7%; n = 576) and all women (25.5%; n = 5138) is similar over the age-range 15-44 years. As in high fertility populations, HIV prevalence is higher in pregnant women at young ages and lower at older ages but the crossover point occurs later due to delayed sexual activity. HIV understatement at older ages due to HIV-associated infertility is mitigated by less HIV infection and less frequent ANC attendance in contraceptive users. The local ANC HIV prevalence estimate is lower [21.2%; n = 1215; risk ratio versus pregnant women in the general population, 0.8; 95% confidence interval (CI), 0.7-1.0], possibly because women from more remote areas are included. ANC estimates overstate the relative risk of HIV in more educated women (age-adjusted odds ratio, 1.1; 95% CI, 0.8-1.4 versus 0.7; 95% CI, 0.6-0.9). CONCLUSIONS: ANC estimates understate female HIV prevalence in this low fertility population but, here, the primary cause is not selection of pregnant women. ANC estimate adjustment procedures that control for contraceptive use and age at first sex are needed.     

Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey

OBJECTIVES: To determine the prevalence of HIV infection, HIV risk factors, and exposure to national HIV prevention programs, and to identify factors associated with HIV infection among South African youth, aged 15-24 years. DESIGN: A cross-sectional, nationally representative, household survey. METHODS: From March to August 2003 we conducted a national survey of HIV prevalence and sexual behavior among 11 904 15-24 year olds. Multivariable models for HIV infection were restricted to sexually experienced youth. RESULTS: Young women were significantly more likely to be infected with HIV in comparison with young men (15.5 versus 4.8%). Among men, a history of genital ulcers in the past 12 months was associated with HIV infection [adjusted odds ratio (AOR), 1.91; 95% confidence interval (CI), 1.04-3.49) whereas among women a history of unusual vaginal discharge in the past 12 months was associated with HIV infection (AOR, 1.75; 95% CI, 1.26-2.44). Young women with older partners were also at increased risk of HIV infection. Among both men and women, increasing partner numbers and inconsistent condom use were significantly associated with HIV infection. Males and females who reported participation in at least one loveLife program were less likely to be infected with HIV (AOR, 0.60; 95% CI, 0.40-0.89; AOR, 0.61; 95% CI, 0.43-0.85, respectively). CONCLUSION: This survey confirms the high HIV prevalence among young people in South Africa and, in particular, young women's disproportionate risk. Programs for youth must continue to promote partner reduction, consistent condom use and prompt treatment for sexually transmitted infections while also addressing contextual factors that make it difficult for them to implement behavior change.     

The association of syphilis with risk of human immunodeficiency virus infection in patients attending sexually transmitted disease clinics

A serologic survey of 4863 patients attending two inner-city sexually transmitted disease clinics was conducted in 1988 1 year after an initial survey to reassess the prevalence and associated risk factors for human immunodeficiency virus (HIV) infection. The HIV seroprevalence rates had not changed significantly (5.2% in 1987, 4.9% in 1988), and remained higher among men (5.6%) than among women (3.6%). The HIV seroprevalence increased steadily with age, to 34 years in women and to 39 years in men. Of patients with a reactive syphilis serologic test result, 24.3% were HIV infected compared with 3.5% of patients with a nonreactive test for syphilis. In multivariate analysis, a reactive serologic test for syphilis was significantly associated with HIV infection in all major risk behavior categories. Among heterosexuals who denied parenteral drug abuse, HIV infection rates were 6.8 and 8.7 times greater for women and men, respectively, who had a reactive serologic test for syphilis. Evidence of heterosexual transmission of HIV was further suggested by a change in HIV seroprevalence in women from 3.0% in 1987 to 3.6% in 1988, a male to female HIV infection ratio of 1.6, and 3.0% prevalence of infection among patients who denied established risk factors. This was most evident among those younger than 25 years, in whom 72% of infected women and 46.2% of infected men denied high-risk behaviors. These data demonstrate the strong association between syphilis and HIV infection and the importance of heterosexual HIV transmission in patients attending sexually transmitted disease clinics. This study underscores the need for a more comprehensive control program for sexually transmitted diseases, including syphilis and HIV infection.     

无锡市重点人群弓形虫感染状况调查

目的了解无锡市重点人群弓形虫感染状况及其影响因素,为制定科学的防治措施提供依据。方法选取无锡市城区艾滋病病毒感染者/病人、肿瘤病人、孕妇、宠物饲养者4类人群为调查对象开展问卷调查,并采血用ELISA法检测抗弓形虫Ig G、Ig M抗体。结果共调查404人,弓形虫抗体阳性38人,总阳性率为9.4%;其中Ig G阳性37人,占97.4%;Ig M阳性1人,占2.6%。多因素分析结果表明年龄、生食食物等不良饮食习惯和接触猫/狗是弓形虫感染的影响因素(OR=2.1、2.6和2.3,P均0.05)。宠物饲养者、HIV/AIDS和肿瘤病人比孕妇更易感染弓形虫(OR=1.5、8.1和2.8,P均0.05)。结论无锡市重点人群弓形虫感染率较高,需要采取针对性措施,加强对免疫缺陷、有不良饮食习惯及宠物饲养者等人群的干预工作。     

Predictors of herpes simplex virus type 2 prevalence and incidence among bar and hotel workers in Moshi, Tanzania

BACKGROUND: Herpes simplex virus (HSV) type 2 increases the risk of human immunodeficiency virus (HIV) infection, and, in regions with high prevalence of both viruses, control of HSV-2 may be an effective method of HIV prevention. Identification of modifiable factors for prevention of HSV-2 infection is essential. We conducted this study among female bar and hotel workers in Moshi, Tanzania. METHODS: Factors associated with prevalent infection were examined among 1039 women. Predictors of incident infection were examined among 360 women initially HSV-2 negative, with at least 1 follow-up visit. RESULTS: HSV-2 prevalence was 56.3% (95% confidence interval [CI], 53.3%-59.3%). Only 2.5% of women able to name a sexually transmitted infection named herpes. Incidence was 14.2 cases/100 person-years (95% CI, 10.5-18.8 cases/100 person-years). Incident HSV-2 infection was independently associated with HIV infection, younger age of sexual initiation, ethnicity, alcohol consumption, and having a male partner with other sexual partners. CONCLUSIONS: The occurrence of HSV-2 is high in this population, but knowledge is low. Development of education programs to increase awareness of HSV-2 is critical. The control of both HSV-2 and HIV infections is a major public health priority in Moshi. Prevention interventions in this and other high prevalence populations might most effectively target younger women, before initiation of sexual activity.     

HIV infection in women utilizing a major hospital in Andhra Pradesh, India, 1993-2004.

BACKGROUND: Despite the high prevalence rates of HIV infection in women, epidemiological studies conducted exclusively on HIV-reactive women are very sparse, particularly from the state of Andhra Pradesh, India, where the overall prevalence rate among antenatal women is 2.1%. STUDY POPULATION: Medical records of 2643 HIV-reactive women, identified during a 12-year period, were reviewed for epidemiological and clinical information about HIV in women. RESULTS: The overall prevalence of HIV-reactive women was 1.6% and trends were in parallel with those observed by the HIV sentinel surveillance study from our state. Overall 24.5% of HIV-infected cases were women, ranging from 6.3% in 1993 to 28.9% in 2004. HIV infection was increasingly found in women over 30 years of age. Heterosexual contact (87.3%) was the most common route of HIV transmission. The majority (75.2%) of the women were asymptomatic. Women, compared to men, suffered more from respiratory and bacterial infections, often pneumonia, and from gender-specific manifestations like vaginal candidal infections. Following the introduction of antiretroviral (ARV) therapy in our hospital in 1999, only 8.5% of HIV-reactive women have received ARV treatment. CONCLUSION: There is a need for gender- and age-specific HIV surveillance among women, especially from areas of high prevalence. Our study shows that there are good reasons to be concerned about the effects of HIV in women. We stress the importance of increasing the focus of attention on the impact of this pandemic on women as we enter the 25th year since its emergence.     

广西1996～2003年艾滋病哨点监测结果分析

目的充分利用广西壮族自治区艾滋病哨点监测资料,进一步掌握广西艾滋病流行现状,使其切实服务于政策开发、预防控制策略和措施的制定,以及干预活动的设计和效果评价。方法按照哨点监测方案在13个点对吸毒者、暗娼、性病门诊就诊者和孕产妇等人群进行监测,监测数据用EPI和SPSS统计软件进行统计分析。结果(1)吸毒人群共用注射器吸毒的比例高达50%以上,艾滋病病毒(HIV)感染在此人群中呈现持续上升的趋势:1996年的监测中未发现HIV感染者,1997年HIV感染率为2.5%,2003年上升为17.0%;(2)暗娼中从不使用安全套的比例较高,约为60.0%,这部分人群中已出现HIV感染;由于部分暗娼为吸毒者,以致某些地方感染率高达10.3%;(3)性病门诊就诊者中性传播疾病的罹患率很高,HIV感染者在各哨点中均有发现,感染率约为0.2%;(4)孕产妇的哨点中也发现了HIV感染者,感染率约为0.1%。结论广西艾滋病的流行已开始从高危人群向一般人群扩散,形势非常严峻。必须尽快采取有效的预防控制措施,减缓艾滋病在广西的流行速度。     

HIV Incidence Among Non-Pregnant Women Living in Selected Rural, Semi-Rural and Urban Areas in Kwazulu-Natal, South Africa

The province of KwaZulu-Natal has the highest prevalence of HIV in South Africa, particularly among young women. In order to more closely examine the HIV prevalence and incidence in non-pregnant women from rural, semi-rural and urban areas, data from 5,753 women screened for enrolment into three HIV prevention studies were combined and analysed. The prevalence of HIV infection was 43% at screening. HIV incidence among the 2,523 enrolled HIV-negative women was determined every quarter, and sexual behaviour and socio-demographic data were collected as per respective protocols. During follow-up, 211 women seroconverted (6.6/100 women years). Multivariate analysis found that seroconversion rates were highest among women who were ≤24?years old, single and not cohabiting, and who had incident sexually transmitted infections. The epidemic in KwaZulu-Natal calls for targeted HIV prevention interventions among those at highest risk of acquiring or transmitting infection.