The HIV epidemic in Zambia: socio-demographic prevalence patterns and indications of trends among childbearing women

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Objective:To examine socio-demographic HIV prevalence patterns and trends among childbearing women in Zambia.Design:Repeated cross-sectional surveys.Methods:Personal interviews and unlinked anonymous testing of blood samples of women attending antenatal care in selected areas.Results:The 1994 data includes information from 27 areas and a total of 11 517 women. The HIV prevalence among urban residents appeared with moderate variation at a very high level (range 25–32%, comparing provinces). The geographical variation was more prominent in rural populations (range 8–16%) and was approximately half the prevalence level of the urban populations. With the exception of the 15–19 years age-group, HIV infection was found to rise sharply with increasing educational attainment (odds ratio, 3.1; confidence interval, 2.6–3.8) when contrasting extreme educational levels. Although the assessment of trends is somewhat restricted, the available information indicates stable prevalence levels in most populations over the last 2–4 years.Conclusions:The data showed extremely high HIV prevalence levels among childbearing women. Longer time-intervals between surveys are needed, however, in order to verify the stability in prevalence identified by this study. The tendency to changing differentials by social status is suggested as a possible sign of an ongoing process of significant behavioural change.

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