Dataset Information

HIV incidence and prevalence among adults aged 15-64 years in Rwanda: Results from the Rwanda Population-based HIV Impact Assessment (RPHIA) and District-level Modeling, 2019.

ABSTRACT:

Objectives

The 2018-2019 Rwanda Population-based HIV Impact Assessment (RPHIA) was conducted to measure national HIV incidence and prevalence. District-level estimates were modeled to inform resources allocation.

Methods

RPHIA was a nationally representative cross-sectional household survey. Consenting adults were interviewed and tested for HIV using the national diagnostic algorithm followed by laboratory-based confirmation of HIV status and testing for viral load (VL), limiting antigen (LAg) avidity, and presence of antiretrovirals. Incidence was calculated using normalized optical density ≤ 1·5, VL ≥ 1,000 copies/mL, and undetectable antiretrovirals. Survey and programmatic data were used to model district-level HIV incidence and prevalence.

Results

Of 31,028 eligible adults, 98·7% participated in RPHIA and 934 tested HIV positive. HIV prevalence among adults in Rwanda was 3·0% (95% CI:2·7-3·3). National HIV incidence was 0·08% (95% CI:0·02-0·14) and 0·11% (95% CI:0·00-0·26) in the City of Kigali (CoK). Based on district-level modeling, HIV incidence was greatest in the 3 CoK districts (0·11% to 0·15%) and varied across other districts (0·03% to 0·10%).

Conclusions

HIV prevalence among adults in Rwanda is 3.0%; HIV incidence is low at 0.08%. District-level modeling has identified disproportionately affected urban hotspots: areas to focus resources.

SUBMITTER: Nsanzimana S

PROVIDER: S-EPMC9069967 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

HIV incidence and prevalence among adults aged 15-64 years in Rwanda: Results from the Rwanda Population-based HIV Impact Assessment (RPHIA) and District-level Modeling, 2019.

Nsanzimana Sabin S Rwibasira Gallican Nshogoza GN Malamba Samuel Sewava SS Musengimana Gentille G Kayirangwa Eugenie E Jonnalagadda Sasi S Fazito Rezende Erika E Eaton Jeffrey W JW Mugisha Veronicah V Remera Eric E Muhamed Semakula S Mulindabigwi Augustin A Omolo Jared J Weisner Lubbe L Moore Carole C Patel Hetal H Justman Jessica E JE

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 20220120

<h4>Objectives</h4>The 2018-2019 Rwanda Population-based HIV Impact Assessment (RPHIA) was conducted to measure national HIV incidence and prevalence. District-level estimates were modeled to inform resources allocation.<h4>Methods</h4>RPHIA was a nationally representative cross-sectional household survey. Consenting adults were interviewed and tested for HIV using the national diagnostic algorithm followed by laboratory-based confirmation of HIV status and testing for viral load (VL), limiting ...[more]

PMID: 35066161

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Project description:BackgroundAdolescent pregnancy, also known as teenage pregnancy, is an unwanted pregnancy affecting girls aged 15-19 years. With a global prevalence of 25%, Africa has 18.8% of female adolescents become pregnant, preventing them from a better standard of living, such as good education and parental care, and adolescent pregnancy, which poses health risks, educational and career disruptions, financial strain, and lower academic achievement, while also increasing public costs and social service demand. This study aimed to determine the prevalence and factors associated with adolescent pregnancy among girls aged 15-19 years in Muhanga district, Rwanda.MethodsThe study involved 392 female adolescents aged 15-19 years in Muhanga district, Rwanda. The participants were selected through a multistage sampling method, and the study ensured voluntary participation whereby the assent and consent forms were signed. Data were collected through questionnaires and analyzed via STATA v.18, and statistical analysis, including chi-square tests and multivariate logistic regression, was used to control for confounders. Ethical approval was obtained from Mount Kenya University and Muhanga district administration.ResultsThe study reported an adolescent pregnancy rate of 10.7% (95% CI: 7.7-13.7). Adolescents financially supported by others (not their parents or guardians) had higher odds of having pregnancy (AOR = 3.9, 95% CI: 1.431-10.467, p < 0.01). Those not in school and primary school showed higher odds of having a pregnancy (AOR = 23.76, 95% CI: 6.833-82.630, p < 0.001) and (AOR = 25.60, 95% CI: 7.224-90.741, p < 0.001), respectively, compared to those in secondary school. Receiving SRH education was associated with lower odds of having a pregnancy (AOR = 0.2, 95% CI: 0.80-0.514, p < 0.001). Experiencing peer pressure increased the odds of having a pregnancy (AOR = 4.12, 95% CI: 1.521-11.131, p < 0.01).ConclusionsThis study highlights a significant adolescent pregnancy rate in Muhanga district, emphasizing the need for targeted interventions. Addressing educational gaps, improving financial support systems, and enhancing sexual and reproductive health education are crucial steps. Policymakers should focus on these areas to reduce adolescent pregnancies and improve outcomes for young girls. Future efforts should also include strategies to counteract peer pressure and integrate comprehensive support programs.

Project description:BackgroundIn 2014, UNAIDS set the goal of ending the AIDS epidemic by 2030 through the achievement of testing and treatment cascade targets. To evaluate progress achieved and highlight persisting gaps in HIV epidemic control in Malawi, we aimed to compare key indicators (prevalence, incidence, viral load suppression, and UNAIDS 95-95-95 targets) from the 2015-16 and 2020-21 Malawi Population-based HIV Impact Assessment (PHIA) survey results.MethodsThe Malawi PHIAs were nationally representative, cross-sectional surveys with a two-stage cluster sampling design. The first survey was conducted between Nov 27, 2015, and Aug 26, 2016; the second survey was conducted between Jan 15, 2020, and April 26, 2021. Our analysis included survey participants aged 15-64 years. Participants were interviewed and a 14 mL blood sample was collected and tested for HIV infection using the national rapid testing algorithm. For each survey, we estimated key HIV epidemic indicators and achievement of 95-95-95 targets. The risk ratio (RR) of the indicators between surveys were computed and considered significant at a confidence level of 0·05. All results were weighted, and self-reported awareness and treatment status were adjusted to account for detection of antiretrovirals.FindingsOur analysis included 17 187 participants aged 15-64 years in 2015-16 and 21 208 in 2020-21 who participated in the surveys and blood draw. In the 2020-21 survey, 88·4% (95% CI 86·7-90·0) of people living with HIV were aware of their HIV-positive status; of those aware, 97·8% (97·1-98·5) were on antiretroviral therapy; and of those on treatment, 96·9% (95·9-97·7) were virally suppressed. Between surveys, the national HIV prevalence decreased significantly from 10·6% (10·0-11·2) to 8·9% (8·4-9·5) with RR 0·85 (95% CI 0·78-0·92; p<0·0001). The annual HIV incidence decreased from 0·37% (0·20-0·53) to 0·22% (0·11-0·34) with RR 0·61 (95% CI 0·31-1·20; p=0·15). The population viral load suppression increased from 68·3% (66·0-70·7) in 2015-16 to 87·0% (85·3-88·5) in 2020-21 (RR 1·27 [95% CI 1·22-1·32]; p<0·0001).InterpretationThese results suggest that Malawi had already surpassed the UNAIDS viral load suppression target for 2030 (85·7%) by 2020-21. Through strategies and evidence-informed interventions implemented in the last half decade, especially scale-up of effective HIV treatment, Malawi has made tremendous progress, including decreasing HIV prevalence and incidence and achieving both the second and third 95 targets ahead of 2030. To address the first 95, efforts in HIV diagnosis should focus on males and younger age groups. There is a continued need for effective linkage to care, retention on antiretroviral therapy, and adherence support to maintain and build on progress.FundingUS President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.

Project description:BackgroundTeenage pregnancy is a significant public health issue and is strongly associated with risky sexual behaviors such as early sexual initiation, unprotected sex, and multiple sexual partners. According to the 2014 World Health Organization report, 11% of all births worldwide were to teenagers aged 15-19 years, with more than 95% of these pregnancies occurring in low- and middle-income countries, particularly in sub-Saharan Africa, which bears much of this burden. In Rwanda, the prevalence of teenage pregnancy has risen from 4.1% in 2005 to 7.3% in 2014, indicating a growing concern. However, there is limited and inconsistent evidence on the factors contributing to teenage pregnancy. Hence, our study aimed to investigate the factors associated with teenage pregnancy. This research seeks to provide valuable insights for targeted interventions, which are urgently needed in light of the increasing rates.MethodsWe employed a cross-sectional study design, utilizing data from the 2019/2020 Rwanda Demographic Health Survey of 3,258 eligible participants aged 15-19 years. To identify factors associated with teenage pregnancy, we performed a bivariate logistic regression analysis. The significant variables from the bivariate analysis were then exported into multivariate logistic regression models, with the results presented as odds ratios (ORs) along with 95% confidence intervals (CIs) and a significance threshold set at 5%.ResultsOur findings indicated that teenagers aged 18-19 years were more likely to experience pregnancy compared to those younger than 17 (OR = 4.2; 95% CI: 2.16-8.37). Adolescents who had engaged in sexual activity 95 times or more had a significantly higher likelihood of becoming pregnant than those with less frequent sexual activity (OR = 13.53; 95% CI: 5.21-35.12). Furthermore, adolescents with parents with a secondary education were 80% less likely to become pregnant compared to those with parents with a primary or no education (OR = 0.2; 95% CI: 0.07-0.63).ConclusionOur study revealed that teenage pregnancy is shaped by several individual factors including age and sexual behavior, along with parental education levels. These findings underscore the critical need for targeted sexual education and enhanced family support systems to mitigate teenage pregnancies. Further, longitudinal studies are essential for establishing causality and guiding effective policy development.

Project description:ImportanceAlcohol consumption is a leading preventable cause of death in the US, and death rates from fully alcohol-attributable causes (eg, alcoholic liver disease) have increased in the past decade, including among adults aged 20 to 64 years. However, a comprehensive assessment of alcohol-attributable deaths among this population, including from partially alcohol-attributable causes, is lacking.ObjectiveTo estimate the mean annual number of deaths from excessive alcohol use relative to total deaths among adults aged 20 to 64 years overall; by sex, age group, and state; and as a proportion of total deaths.Design, setting, and participantsThis population-based cross-sectional study of mean annual alcohol-attributable deaths among US residents between January 1, 2015, and December 31, 2019, used population-attributable fractions. Data were analyzed from January 6, 2021, to May 2, 2022.ExposuresMean daily alcohol consumption among the 2 089 287 respondents to the 2015-2019 Behavioral Risk Factor Surveillance System was adjusted using national per capita alcohol sales to correct for underreporting. Adjusted mean daily alcohol consumption prevalence estimates were applied to relative risks to generate alcohol-attributable fractions for chronic partially alcohol-attributable conditions. Alcohol-attributable fractions based on blood alcohol concentrations were used to assess acute partially alcohol-attributable deaths.Main outcomes and measuresAlcohol-attributable deaths for 58 causes of death, as defined in the Centers for Disease Control and Prevention's Alcohol-Related Disease Impact application. Mortality data were from the National Vital Statistics System.ResultsDuring the 2015-2019 study period, of 694 660 mean deaths per year among adults aged 20 to 64 years (men: 432 575 [66.3%]; women: 262 085 [37.7%]), an estimated 12.9% (89 697 per year) were attributable to excessive alcohol consumption. This percentage was higher among men (15.0%) than women (9.4%). By state, alcohol-attributable deaths ranged from 9.3% of total deaths in Mississippi to 21.7% in New Mexico. Among adults aged 20 to 49 years, alcohol-attributable deaths (44 981 mean annual deaths) accounted for an estimated 20.3% of total deaths.Conclusions and relevanceThe findings of this cross-sectional study suggest that an estimated 1 in 8 total deaths among US adults aged 20 to 64 years were attributable to excessive alcohol use, including 1 in 5 deaths among adults aged 20 to 49 years. The number of premature deaths could be reduced with increased implementation of evidenced-based, population-level alcohol policies, such as increasing alcohol taxes or regulating alcohol outlet density.

Project description:BackgroundWorldwide, an estimated 38.0 million people lived with the human immunodeficiency virus in 2019, and 3.4 million young people aged 15~24 years were living with HIV. Sub-Saharan Africa carries a significant HIV burden with West and Central Africa most affected with HIV. Among the young people living with HIV in West and Central Africa, an estimated 810,000 were aged 15~24 years. This study aimed to assess predictors that influence the uptake of HIV testing among youth aged 15~24 years in The Gambia.MethodsThe 2013 Gambia Demographic and Health Survey data for youth aged 15~24 years was used. The Andersen behavioral model of health service use guided this study. A cross-sectional study design was used on 6194 subjects, among which 4730 were female. The analysis employed Chi-squared tests and hierarchical logistic regression.ResultsLess than one-quarter of the youth 1404 (22.6%) had ever been tested for HIV. Young people aged 20~24 years (adjusted odds ratio (aOR): 1.98), who were females (aOR: 1.13), married youth (aOR: 3.89), with a primary (aOR: 1.23), secondary or higher education (aOR: 1.46), and who were from the Jola/Karoninka ethnic group (aOR: 1.81), had higher odds of having been tested for HIV. Those with adequate HIV knowledge and those who were sexually active and had aged at first sex ≥15 years (aOR: 3.99) and those <15 years (aOR: 3.96) were more likely to have been tested for HIV compared to those who never had sex.ConclusionThis study underscores the low level of model testing on HIV testing among youth (15~24 years) in The Gambia. Using Anderson's Model of Health Service Utilization, the predisposing factors (socio-demographic and HIV knowledge) and the need-for-care factors (sexual risk behaviors) predict healthcare utilization services (HIV testing) in our study; however, only socio-demographic model explained most of the variance in HIV testing. The low effect of model testing could be related to the limited number of major variables selected for HIV knowledge and sexual risk behavior models. Thus, consideration for more variables is required for future studies.

Dataset Information

HIV incidence and prevalence among adults aged 15-64 years in Rwanda: Results from the Rwanda Population-based HIV Impact Assessment (RPHIA) and District-level Modeling, 2019.

Objectives

Methods

Results

Conclusions

Publications

HIV incidence and prevalence among adults aged 15-64 years in Rwanda: Results from the Rwanda Population-based HIV Impact Assessment (RPHIA) and District-level Modeling, 2019.

Similar Datasets

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