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Prevention/Epidemiology
Regional Differences in HIV Trends in The Gambia: Results From Sentinel Surveillance Among Pregnant Women

September 15, 2003

The current study compared the seroprevalence of HIV-1 and HIV-2 in pregnant women in The Gambia between May 2000 and August 2001 with the seroprevalence of the viruses in 1993-1995. The earlier survey found HIV-1 at 0.6 percent and HIV-2 at 1.1 percent among pregnant women who visited eight antenatal clinics throughout the country. The later survey, conducted at four of the original sites from the 1993-1995 study, collected 8,054 blood samples between May 2000 and August 2001. Analysis found the prevalence of HIV-1 had risen sharply in one rural area, from 0.6 percent to 3.0 percent, but no significant increases in two other rural sites and an urban site. The overall prevalence of HIV-2 decreased from 1.0 percent to 0.8 percent, not a statistically significant change, according to the study. The researchers found that HIV-1 had overtaken HIV-2 as the predominant virus.

HIV-1 infected women were an average of 1.4 years older than seronegative women. At Sibanor, a rural site, HIV-1 prevalence was significantly higher among Senegalese women compared with Gambian women, a difference not observed at other sites. HIV-2 infected women were an average of 2.1 years older than seronegative women.

"Fifteen years after the first case of HIV-1, the prevalence is still low in The Gambia, and the same is true in Senegal," the researchers wrote. The scientists cite male circumcision -- nearly universal in The Gambia -- as a protective factor along with the lower incidence of herpes simplex virus type 2 in The Gambia as compared to East Africa. "HIV-1 prevalences have been lowest in Muslim countries of North Africa and The Middle East," the authors noted, "and this is likely to be linked to sexual behavior. As over 95 percent of the Gambian population is Muslim, the same reasons could underlie the low prevalence in Senegal and The Gambia. Studies on sexual behavior in The Gambia are needed to interpret the low prevalence further," the authors concluded.

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Excerpted from:
AIDS
08.15.03; Vol. 17; No. 12; P.1841-1846; Maarten F. Schim van der Loeff; Ramu Sarge-Njie; Saihou Ceesay; Akum Aveika Awasana; Pa Jaye; Omar Sam; Kebba O. Jaiteh; David Cubitt; Paul Milligan; Hilton C. Whittle




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