Care and support for people living with HIV/AIDS
Care and support for people living with HIV/AIDS
Care and support for people living with HIV/AIDS
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Annex 1.How reliable are estimates of <strong>HIV</strong> infection <strong>and</strong> <strong>AIDS</strong> deaths?ies in urban <strong>and</strong> rural communities have made it possible to validate the results ofsentinel surveillance in pregnant women. These studies offer important insights intothe differentials of <strong>HIV</strong> infection by age <strong>and</strong> sex. They also confirm that sentinel surveillancein pregnant women yields remarkably robust estimates <strong>for</strong> <strong>HIV</strong> prevalencein the general population of reproductive age, as shown in Figure 28.Figure 28. <strong>HIV</strong> prevalence rates among pregnant women <strong>and</strong> amongall adults aged 15-49%3530pregnant womenall adults2520151050Lusaka,Zambia1994-1996MposhiZambia1994-1996Mwanza,Tanzania1990-1991Rakai,Ug<strong>and</strong>a1990Rakai,Ug<strong>and</strong>a1991Rakai,Ug<strong>and</strong>a1992Kisumu,Kenya1998Source: Sentinel surveillance data from antenatal clinics <strong>and</strong> population-based studies, selected Africancountries, 1990-1998In countries where the <strong>HIV</strong> epidemic is concentrated in a few groups <strong>with</strong> high-riskbehaviour – mostly drug injectors <strong>and</strong> men who have sex <strong>with</strong> men, as well as sexworkers <strong>and</strong> their clients – the methods <strong>for</strong> estimating <strong>HIV</strong> prevalence are different.This is the case in most countries in Asia, the Americas <strong>and</strong> Europe. Here, becausethere are very few <strong>HIV</strong> infections in the general population, <strong>and</strong> because many of theinfections are in groups largely or entirely made up of men, data from pregnantwomen are of very limited use. Rather, <strong>HIV</strong> estimates in such cases are based onin<strong>for</strong>mation on <strong>HIV</strong> prevalence in each group of <strong>people</strong> <strong>with</strong> high-risk behaviour,together <strong>with</strong> estimates of the size of each of these populations. Since these behavioursare often socially unacceptable <strong>and</strong> sometimes illegal, in<strong>for</strong>mation on both <strong>HIV</strong>prevalence levels <strong>and</strong> the size of the population affected can be much harder tocome by. Consequently, uncertainties around these estimates may well be greater<strong>for</strong> countries where the epidemic is concentrated in specific groups.117