Prevention of perinatal HIV transmission: are there alternatives to pre-pregnancy serological screening in Kinshasa, Zaire?
Complete obstetrical and medical histories were obtained from 6312 women between the ages of 15 and 45 years who had undergone HIV serological tests. Individual factors were examined for sensitivity, specificity and positive predictive value of HIV infection. No individual risk factors for HIV infection were identified which had sensitivities greater than 60%. Combinations of factors were modelled by logistic regression. Only a model which included indicators of present illness with AIDS/HIV-related symptoms (i.e., chronic fever, diarrhea or profound weight loss) was predictive of HIV serostatus. These results suggest that identification of healthy women at high risk of HIV infection using non-serological information is not feasible. Thus, since the yearly cost of universal serological screening is prohibitively expensive in the Zairean context, HIV/AIDS education and prevention campaigns may in fact be a more cost-effective means of preventing perinatal transmission of HIV.
Hassig
S E
SE
Projet SIDA, Department of Public Health, Kinshasa, Zaire.
Kinkela
N
N
Nsa
W
W
Kamenga
M
M
Ndilu
M
M
Francis
H
H
Ryder
R W
RW
D000293:Adolescent; D000328:Adult; D015023:Democratic Republic of the Congo; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D015528:HIV Seroprevalence; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012698:Serologic Tests