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Trends of HIV-1 and sexually transmitted diseases among pregnant
and postpartum women in urban Malawi
Taha, TE | Dallabetta, GA | Hoover, DR | Chiphangwi, JD | Mtimavalye,
LAR | Liomba, GN | Kumwenda, NI | Miotti, PG
AIDS [AIDS]. Vol. 12, no. 2, pp. 197-203. 22 Jan 1998.
Objectives: To examine rates of HIV-1 and sexually transmitted
disease (STD) among pregnant and postpartum women in urban Malawi,
Africa. Design: Serial cross-sectional surveys and a prospective
study. Methods: Three major surveys were conducted in 1990, 1993
and 1994/1995. Consecutive first-visit antenatal women and women
giving birth at the Queen Elizabeth Central Hospital were tested
for HIV and STD after counseling and obtaining informed consent.
Unlinked, anonymous HIV testing was also conducted on smaller
samples of antenatal women in the same hospital to provide annual
prevalence data. HIV-seronegative postpartum women from the 1990
and 1993 surveys were enrolled in a prospective study to determine
HIV incidence. Results: HIV seroprevalence rose from 2.0% in 1985
to 32.8% in 1996, a 16-fold increase. The highest age-specific HIV
prevalence was in the following age-groups: 20-24 years during
1990, 25-29 years during 1993, and 30-34 years during 1996. Among
1173 women followed for a median of 30.9 months, HIV incidence was
5.98 per 100 person-years in women aged < 20 years and declined
steadily in older women. The prevalence of STD significantly
declined among both HIV-positive and negative women. This decline
in STD prevalence, however, was not accompanied by increased
condom use over time. Conclusions: Among urban childbearing women
in Malawi, incidence of HIV is highest among young women while,
currently, prevalence is highest among older women. Recent
declines in STD prevalence suggest that HIV prevention programs
are having an impact either through improved STD diagnosis and
treatment or reduced risk behaviors. Sequential cross-sectional
STD prevalence measures may be useful in monitoring effectiveness
of STD and HIV prevention activities.
 Descriptors: Article Subject Terms Females | Postpartum | Pregnancy | Sexually-transmitted
diseases | Urban areas | Urban environments | Article Taxonomic Terms Human
immunodeficiency virus 1
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