A new study in the latest American Journal of Epidemiology has confirmed what experts have long suspected – that HIV infection rates based on the national antenatal surveys could well be an underestimate.
Scientists have known for some time now that using pregnant women to establish infection rates in the general population may result in an under-estimate because HIV causes infertility and, as a result, women with HIV are less likely to become pregnant.
But the new American study, which was conducted by the Johns Hopkins School of Public Health, is important because it puts an exact percentage into the equation. What it shows is that the fertility of HIV-infected women is in fact 37 percent less than that of healthy women.
“This is an important confirmation and needs to be taken into account in interpreting antenatal HIV survey data and in modelling the epidemic into the future,” says Dr Malcolm Steinberg, an HIV/AIDS consultant from Apt Associates in Johannesburg.
The study has implications which go well beyond the interpretation of antenatal survey data. It also implies that fertility in general will be drastically reduced as a direct consequence of the HIV epidemic.
Steinberg suggests, however, that the results of the study should be interpreted with caution. He points out that it is extremely difficult to extrapolate from developed countries such as the United States, where this study was conducted, to developing countries such as South Africa.
Pregnant women who attend antenatal services are used to establish general infection rates because they are generally considered to be representative of normal, healthy sexually active women in the population at large.
According to South Africa’s latest antenatal survey, 22,4% of pregnant women tested at state hospitals are HIV positive. – Health-e News Service.