Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review  

Oleh:

Spiegel, Paul B ; Bennedsen, Anne Rygaard ; Claass, Johanna ; Bruns, Laurie ; Patterson, Njogu ; Yiweza, Dieudonne ; Schilperoord, Marian

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Lancet (keterangan: ada di Proquest) vol. 369 no. 9580 (Jun. 2007), page 2187.

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Perpustakaan FK Nomor Panggil: L01.K.2007.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Violence and rape are believed to fuel the HIV epidemic in countries affected by conflict. We comp< HIV prevalence in populations directly affected by conflict with that in those not directly affected and in refu~ versus the nearest surrounding host communities in sub-Saharan African countries. Methods Seven countries affected by conflict (Democratic Republic of Congo, southern Sudan, Rwanda, Ugar Sierra Leone, Somalia, and Burundi) were chosen since HIV prevalence surveys within the past 5 years had b done and data, including original antenatal-care sentinel surveillance data, were available. We did a systematic ; comprehensive literature search using Medline and Embase. Only articles and reports that contained original data prevalence of HIV infection were included. All survey reports were independently evaluated by two epidemiolog to assess internationally accepted guidelines for HIV sentinel surveillance and population-based surveys. When{ possible, data from the nearest antenatal care and host country sentinel site of the neighbouring countries" presented. 95% CIs were provided when available. . Findings Of the 295 articles that met our search criteria, 88 had original prevalence data and 65 had data from seven selected countries. Data from these countries did not show an increase in prevalence of HIV infection dur periods of conflict, irrespective of prevalence when conflict began. Prevalence in urban areas affected by con! decreased in Burundi, Rwanda, and Uganda at similar rates to urban areas unaffected by conflict in their res pee countries. Prevalence in conflict-affected rural areas remained low and fairly stable in these countries. Of the 12 ! of refugee camps, nine had a lower prevalence of HI V infection, two a similar prevalence, and one a higher prevalel than their respective host communities. Despite wide-scale rape in many countries, there are no data to show t rape increased prevalence of HIV infection at the population level. Interpretation We have shown that there is a need for mechanisms to provide time-sensitive information on the eft of conflict on incidence of HIV infection, since we found insufficient data to support the assertions that confl forced displacement, and wide-scale rape increase prevalence or that refugees spread HIV infection in h communities.

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