Skip to main content

Free Content Differences in fertility by HIV serostatus and adjusted HIV prevalence data from an antenatal clinic in northern Uganda

Download Article:

You have access to the full text article on a website external to Ingenta Connect.

Please click here to view this article on Wiley Online Library.

You may be required to register and activate access on Wiley Online Library before you can obtain the full text. If you have any queries please visit Wiley Online Library

Abstract:

Summary 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.

Keywords: Africa; HIV; fertility; surveillance

Document Type: Research Article

DOI: https://doi.org/10.1111/j.1365-3156.2005.01554.x

Affiliations: 1: National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy 2: St. Mary's Hospital Lacor, Gulu, Uganda

Publication date: 2006-02-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more