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2005
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20 Nov 2005
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HIV INFECTION
Saphonn V, Hor LB, Ly SP, Chhuon S, Saidel T, Detels R. How well do antenatal
clinic (ANC) attendees represent the general population? A comparison of HIV
prevalence from ANC sentinel surveillance sites with a population-based survey
of women aged 15-49 in Cambodia. Int J Epidemiol. 31(2):449-55, 2002.
BACKGROUND: The purpose of this study was to evaluate
whether HIV-1 prevalence among antenatal clinic (ANC) attendees in Cambodia
provided a reasonable estimate of HIV-1 prevalence among all women 15-49 years.
METHODS Antenatal clinic attendees in five HIV sentinel surveillance sites (five
provinces) were selected by consecutive sampling (n = 1695). The population
survey of females by household was carried out in the same five areas. Household
females aged 15-49 years were selected using a three-stage cluster sampling
design (n = 3066). Serum-based HIV ELISA testing was done for both ANC attendees
and household females. The HIV prevalence for ANC attendees and household
females were compared by age group and urban versus rural location. RESULTS: The
overall prevalence of HIV-1 infection among ANC attendees (1.62%, 95% CI :
1.26-1.98) was similar to the overall prevalence obtained from the general
population of household females (1.24%, 95% CI : 0.92-1.55) in the same
catchment areas in Cambodia. In the rural areas, the overall HIV prevalence
among ANC attendees (2.18%, 95% CI : 1.59-2.77) was significantly higher than
among the household females (0.86%, 95% CI : 0.49-1.23) after adjustment for age
distribution and education level. In the 15-24 age group in rural areas, the HIV
prevalence of ANC women was 2.71% (95% CI : 0.96-4.46) compared with 0.77% (95%
CI : 0.02-1.53) in household females. CONCLUSIONS: Although ANC data can be used
to estimate trends over time, it should be realized that ANC data may
overestimate the actual prevalence in the younger age group in rural areas in
Cambodia.
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