title: Within-Gender Changes in HIV Prevalence among Adults between 2005/6 and 2010/11 in Zimbabwe.
abstract: BACKGROUND
  Zimbabwe has reported significant declines in HIV prevalence between 2005/06 and 2010/11 Demography and Health Surveys; a within-gender analysis to identify the magnitude and factors associated with this change, which can be masked, is critical for targeting interventions.
  
  
  METHODS
  We analyzed change in HIV prevalence for 6,947 women and 5,848 men in the 2005/06 survey and 7,313 women and 6,250 men in 2010/11 surveys using 2005/06 as referent. The data was analyzed taking into consideration the survey design and therefore the svy, mean command in Stata was used in both linear and logistic regression.
  
  
  RESULTS
  There were similar proportional declines in prevalence at national level for males (15% p=0.011) and females (16%,p=0.008). However, there were variations in decline by provincial setting, demographic variables of age, educational level and some sexual risk behaviours. In logistic regression analysis, statistically significant declines were observed among men in Manicaland, Mashonaland East and Harare (p<0.01) and for women in Manicaland, Mashonaland Central and Harare (p<0.01). Although not statistically significant, numerical increases were observed among men in Matebeleland North, Matebeleland South, Midlands and for both men and women in Bulawayo. Young women in the age range 15-34 experienced a decline in prevalence (p<0.01) while older men 30-44 had a statistically significant decline (p<0.01). Having a secondary and above education, regardless of employment status for both men and women recorded a significant decline. For sexual risk behaviours, currently in union for men and women and not in union for women there was a significant decline in prevalence.
  
  
  CONCLUSIONS
  Zimbabwe has reported a significant decline among both men and women but there are important differentials across provinces, demographic characteristics and sexual risk behaviours that suggest that the epidemic in Zimbabwe is heterogeneous and therefore interventions must be targeted in order to achieve epidemic control.
authors.affiliation: U.S. Centers for Disease Control and Prevention (CDC), Harare Zimbabwe.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gonese
authors.affiliation: National Blood Service Zimbabwe, Harare Zimbabwe; Unit of Pharmaco-Epidemiology & Pharmaco-Economics (PE2), Department of Pharmacy, University of Groningen, Groningen, Netherlands.
authors.forename: Tonderai
authors.initials: T
authors.lastname: Mapako
authors.affiliation: Ministry of Health and Child Welfare, Harare, Zimbabwe.
authors.forename: Janet
authors.initials: J
authors.lastname: Dzangare
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.affiliation: U.S. Centers for Disease Control and Prevention (CDC), Harare Zimbabwe; Division of Global HIV/AIDS, CDC, Atlanta, United States of America.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kilmarx
authors.affiliation: Unit of Pharmaco-Epidemiology & Pharmaco-Economics (PE2), Department of Pharmacy, University of Groningen, Groningen, Netherlands.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Postma
authors.affiliation: National Microbiology Reference Laboratory, Harare, Zimbabwe.
authors.forename: Stella
authors.initials: S
authors.lastname: Ngwende
authors.affiliation: U.S. Centers for Disease Control and Prevention (CDC), Harare Zimbabwe.
authors.forename: John
authors.initials: J
authors.lastname: Mandisarisa
authors.affiliation: Ministry of Health and Child Welfare, Harare, Zimbabwe.
authors.forename: Ponesai
authors.initials: P
authors.lastname: Nyika
authors.affiliation: National Blood Service Zimbabwe, Harare Zimbabwe.
authors.forename: David A
authors.initials: DA
authors.lastname: Mvere
authors.affiliation: Ministry of Health and Child Welfare, Harare, Zimbabwe.
authors.forename: Owen
authors.initials: O
authors.lastname: Mugurungi
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Mufuta
authors.initials: M
authors.lastname: Tshimanga
authors.affiliation: Unit of Pharmaco-Epidemiology & Pharmaco-Economics (PE2), Department of Pharmacy, University of Groningen, Groningen, Netherlands; Department of Clinical Pharmacy and Toxicology, Martini Hospital, Groningen, Netherlands.
authors.forename: Marinus van
authors.initials: Mv
authors.lastname: Hulst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006306:Health Surveys / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology