The incidence of HIV among women recruited during late pregnancy and followed up for six years after childbirth in ZimbabweReport as inadecuate

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BMC Public Health

, 10:668

First Online: 03 November 2010Received: 10 July 2010Accepted: 03 November 2010DOI: 10.1186-1471-2458-10-668

Cite this article as: Munjoma, M.W., Mhlanga, F.G., Mapingure, M.P. et al. BMC Public Health 2010 10: 668. doi:10.1186-1471-2458-10-668


BackgroundHIV incidence is a useful tool for improving the targeting of populations for interventions and assessing the effectiveness of prevention strategies. A study in Harare, Zimbabwe reported cumulative incidences of 3.4% 3.0-3.8 and 6.5% 5.7-7.4 among post-partum women followed for 12 and 24 months respectively between 1997 and 2001. According to a Government report on HIV the prevalence of HIV fell from about 30% in 1999 to 14% in 2008. The purpose of this study was to determine the incidence of HIV-1 among women enrolled during late pregnancy and followed for six years after childbirth and to identify risk factors associated with acquisition of HIV.

MethodsHIV-uninfected pregnant women around 36 weeks gestation were enrolled from primary health care clinics in peri-urban settlements around Harare and followed-up for up to six years after childbirth. At every visit a questionnaire was interview-administered to obtain socio-demographic data and sexual history since the previous visit. A genital examination was performed followed by the collection of biological samples.

ResultsOf the 552 HIV-uninfected women 444 80.4% were seen at least twice during the six years follow-up and 39 acquired HIV, resulting in an incidence 95% CI of 2.3-100 woman-years-at-risk wyar 1.1-4.1. The incidence over the first nine months post-partum was 5.7-100 wyar 3.3-8.1. A greater proportion of teenagers 15.3% contributed to a high incidence rate of 2.9-100 0.6-8.7 wyar. In multivariate analysis lower education of participant, RR 2.1 1.1-4.3 remained significantly associated with HIV acquisition. Other risk factors associated with acquisition of HIV-1 in univariate analysis were young age at sexual debut, RR 2.3, 1.0-5.6 and having children with different fathers, RR 2.71.3-5.8. Women that knew that their partners had other sexual partners were about four times more likely to acquire HIV, RR 3.8 1.3-11.2.

ConclusionThe incidence of HIV was high during the first nine months after childbirth. Time of seroconversion, age and educational level of seroconverter are important factors that must be considered when designing HIV intervention strategies.

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Author: Marshall W Munjoma - Felix G Mhlanga - Munyaradzi P Mapingure - Edith N Kurewa - Grace V Mashavave - Mike Z Chirenje -


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