Can data from programs for the prevention of mother-to-child transmission of HIV be used for HIV surveillance in Kenya?
OBJECTIVE
In Africa, HIV surveillance is conducted among antenatal clinic (ANC) attendees using unlinked-anonymous testing (UAT). In Kenya, the utility of prevention of mother-to-child transmission (PMTCT) program data for HIV surveillance was evaluated.


METHODS
UAT and PMTCT data were compared at the same clinics and for the same time (2003 UAT survey) period. The HIV testing uptake for PMTCT was defined as the number of ANC attendees tested for HIV out of those who had their first ANC visit during the ANC surveillance period. Odds ratios and 95% confidence intervals were calculated to determine associations between demographic characteristics and HIV testing acceptance.


RESULTS
Of 39 ANC-UAT sites, six had PMTCT data. PMTCT data were recorded across several logbooks with varying quality. For PMTCT, 2,239 women were offered HIV testing and 1,258 (56%) accepted; for UAT, 1,852 women were sampled. Median UAT-based HIV prevalence was 12.8% (range, 8.1%-26.3%) compared with 14.4% (range, 7.0%-27.2%) in PMTCT. HIV testing acceptance for PMTCT ranged from 48% to 69% across clinics, and was more likely among primigravidae than multigravidae.


CONCLUSIONS
Because of varying PMTCT data quality and varying HIV testing acceptance for PMTCT, PMTCT-based HIV prevalence estimates cannot currently replace UAT-based estimates in Kenya.
Seguy
Nicole
N
Global AIDS Program/National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E-30, Atlanta, GA 30333, USA.
Hladik
Wolfgang
W
Munyisia
Esther
E
Bolu
Omotayo
O
Marum
Larry H
LH
Diaz
Theresa
T
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006679:HIV Seropositivity / Q000175:diagnosis; D019538:Health Care Surveys; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007630:Kenya / Q000453:epidemiology; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance / Q000379:methods*; D011295:Prenatal Care