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2005
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20 Nov 2005
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HIV INFECTION
Fontanet AL, Messele T, Dejene A, Enquselassie F, Abebe A, Cutts FT, Rinke de
Wit T, Sahlu T, Bindels P, Yeneneh H, Coutinho RA, Nokes DJ. Age- and
sex-specific HIV-1 prevalence in the urban community setting of Addis Ababa,
Ethiopia. AIDS 12(3), 315-22, 1998.
OBJECTIVE: To estimate the age and sex-specific prevalence
of HIV infection in the population of Addis Ababa, Ethiopia. DESIGN: Two-stage
cluster sampling of the population aged 0-49 years of Addis Ababa, using kebeles
(urban dwelling associations) as clusters. METHODS: The sera used for this study
were collected in an earlier study (1994) on the rate of acquisition of
antibodies against measles, rubella, and hepatitis B. After separate approvals
were obtained from the institutional ethics committees, sera were tested by
enzyme-linked immunosorbent assay confirmed by Western blot. Age- and
sex-specific HIV prevalence rates were estimated. The prevalence of HIV in men
and women over 15 years of age was compared by calculating age-standardized HIV
prevalence, using the age distribution of the census population as the standard.
A time-dependent catalytic model was used to obtain crude estimates of HIV
incidence from age-prevalence data. RESULTS: A total of 3853 sera were available
for analysis. The prevalence of HIV in adults was 6.0% [95% confidence interval
(CI), 4.5-7.4%] for men and 6.9% (95% CI, 5.3-8.5%) for women, with peak
prevalence in the 25-29 year age group of 16.3 and 11.8%, respectively. After
standardization for age using the direct method, the HIV prevalence ratio
comparing adult men with women was 0.97:1 (95% CI, 0.70:1 - 1.35:1). Three
children aged less than 5 years were HIV-positive. The prevalence of HIV among
adults ranged from 0-21.3% in different clusters, indicating the heterogeneity
of the spread of HIV in the city. HIV prevalence estimates among the antenatal
clinic patients of Addis Ababa in 1996 far exceeded the estimates obtained
during the community survey, particularly in the youngest age group (15-24
years). Estimates of HIV incidence (per susceptible person per annum) for the
age group 16-22 years ranged from 1.3-2.25% for men and from 2.1-2.4% for women.
CONCLUSION: By 1994, a substantial proportion of the adult population of Addis
Ababa was infected with HIV. Promotion of behavioural changes and the control of
sexually transmitted diseases should be strongly supported to limit the spread
of the HIV epidemic in Ethiopia.
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