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Differences in fertility by HIV serostatus and adjusted HIV prevalence data from an antenatal clinic in northern Uganda.
Trop Med Int Health. 2006 Feb; 11(2):182-7.TM

Abstract

OBJECTIVES

To estimate differences in fertility by HIV serostatus and to validate an adjustment method for estimating the HIV prevalence in the general female population using data from an antenatal clinic.

METHODS

We used Cox regression models to retrospectively estimate the age-specific relative fertility (RF) of HIV-positive compared to HIV-negative women among 3314 antenatal clinic attenders in northern Uganda. RF and the age distribution of women in the general female population were used to extrapolate the antenatal clinic-based HIV prevalence. This procedure was indirectly validated by comparing the adjusted estimate with those based on standard adjustment factors derived from general female populations in Uganda and Tanzania.

RESULTS

HIV-positive women reported a lower fertility than HIV-negative women [age-adjusted RF=0.83, 95% confidence interval (CI): 0.75-0.93]. Except for girls aged 15-19 (RF=0.96, 95% CI: 0.74-1.24) HIV-positive women in all age groups were less fertile (20-24 year: RF=0.83, 95% CI: 0.67-1.01; 25-29 years: RF=0.79, 95% CI: 0.62-1.00; 30-49 year: RF=0.79, 95% CI: 0.65-0.96]. Adjusting the antenatal clinic-based HIV prevalence (11.6%) for these differences yields a higher estimate (13.8%) that is lower than those based on standard adjustment factors derived from general female populations (from 14.6% to 17.7%).

CONCLUSIONS

The age-specific pattern of differential fertility by HIV serostatus derived from antenatal clinic data is consistent with findings from population-based studies conducted in Africa. However, differences in fertility between HIV positive and HIV-negative clients underestimate those in the general female population yielding inaccurate estimates when used to extrapolate the HIV prevalence.

Authors+Show Affiliations

National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy. fabiani@iss.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16451342

Citation

Fabiani, Massimo, et al. "Differences in Fertility By HIV Serostatus and Adjusted HIV Prevalence Data From an Antenatal Clinic in Northern Uganda." Tropical Medicine & International Health : TM & IH, vol. 11, no. 2, 2006, pp. 182-7.
Fabiani M, Nattabi B, Ayella EO, et al. Differences in fertility by HIV serostatus and adjusted HIV prevalence data from an antenatal clinic in northern Uganda. Trop Med Int Health. 2006;11(2):182-7.
Fabiani, M., Nattabi, B., Ayella, E. O., Ogwang, M., & Declich, S. (2006). Differences in fertility by HIV serostatus and adjusted HIV prevalence data from an antenatal clinic in northern Uganda. Tropical Medicine & International Health : TM & IH, 11(2), 182-7.
Fabiani M, et al. Differences in Fertility By HIV Serostatus and Adjusted HIV Prevalence Data From an Antenatal Clinic in Northern Uganda. Trop Med Int Health. 2006;11(2):182-7. PubMed PMID: 16451342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in fertility by HIV serostatus and adjusted HIV prevalence data from an antenatal clinic in northern Uganda. AU - Fabiani,Massimo, AU - Nattabi,Barbara, AU - Ayella,Emingtone O, AU - Ogwang,Martin, AU - Declich,Silvia, PY - 2006/2/3/pubmed PY - 2006/3/22/medline PY - 2006/2/3/entrez SP - 182 EP - 7 JF - Tropical medicine & international health : TM & IH JO - Trop Med Int Health VL - 11 IS - 2 N2 - OBJECTIVES: To estimate differences in fertility by HIV serostatus and to validate an adjustment method for estimating the HIV prevalence in the general female population using data from an antenatal clinic. METHODS: We used Cox regression models to retrospectively estimate the age-specific relative fertility (RF) of HIV-positive compared to HIV-negative women among 3314 antenatal clinic attenders in northern Uganda. RF and the age distribution of women in the general female population were used to extrapolate the antenatal clinic-based HIV prevalence. This procedure was indirectly validated by comparing the adjusted estimate with those based on standard adjustment factors derived from general female populations in Uganda and Tanzania. RESULTS: HIV-positive women reported a lower fertility than HIV-negative women [age-adjusted RF=0.83, 95% confidence interval (CI): 0.75-0.93]. Except for girls aged 15-19 (RF=0.96, 95% CI: 0.74-1.24) HIV-positive women in all age groups were less fertile (20-24 year: RF=0.83, 95% CI: 0.67-1.01; 25-29 years: RF=0.79, 95% CI: 0.62-1.00; 30-49 year: RF=0.79, 95% CI: 0.65-0.96]. Adjusting the antenatal clinic-based HIV prevalence (11.6%) for these differences yields a higher estimate (13.8%) that is lower than those based on standard adjustment factors derived from general female populations (from 14.6% to 17.7%). CONCLUSIONS: The age-specific pattern of differential fertility by HIV serostatus derived from antenatal clinic data is consistent with findings from population-based studies conducted in Africa. However, differences in fertility between HIV positive and HIV-negative clients underestimate those in the general female population yielding inaccurate estimates when used to extrapolate the HIV prevalence. SN - 1360-2276 UR - https://www.unboundmedicine.com/medline/citation/16451342/Differences_in_fertility_by_HIV_serostatus_and_adjusted_HIV_prevalence_data_from_an_antenatal_clinic_in_northern_Uganda_ L2 - https://doi.org/10.1111/j.1365-3156.2005.01554.x DB - PRIME DP - Unbound Medicine ER -