Introduction Southern African countries bear an inordinate burden of the global HIV/AIDS pandemic. Monitoring the epidemiology dynamics is critical to identify populations at greatest risk for the infection and assess the maturity of the epidemic.
Methods A cross-sectional population-based study was designed to determine age and sex-specific community HIV prevalence in adults aged 18–47 years old living in Manhiça district, in southern Mozambique. Study candidates were randomly selected from the Demographic Surveillance System in place at the Centro de Investigação em Saúde de Manhiça (CISM) and home-based testing was conducted. The population-based HIV prevalence results were compared with those obtained prospectively from the antenatal clinics (ANC) of Manhiça Health Center.
Results In total, 722 adults participated in the cross-sectional survey. The overall HIV prevalence found in adults aged 18–27 years was 23.61% (95% CI 18.13 to 29.08), increasing to 42.62% (95% CI 36.39 to 48.85) in those aged 28–37 years and to 45.31% (95% CI 39.05 to 51.56) in the 38–47 years age-group. HIV prevalence estimates were higher in women than in men, especially in younger adults. The overall HIV prevalence found in the study participants was of 37.40% (95% CI 33.86 to 40.93). Analysis of the ANC data showed an HIV prevalence of 29.35% (95% CI 26.70 to 32.00) in 952 pregnant women from the same area.
Conclusions Our results show higher HIV prevalence in the population-based survey than in the ANC surveillance system of the same district. This raises issues as to the applicability of ANC prevalence data to estimate overall HIV prevalence, and stresses the need for innovative prevention strategies in sub-Saharan countries.
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