Epidemiology of Hiv

Topics: HIV, AIDS, Antiretroviral drug Pages: 44 (14915 words) Published: March 8, 2011
Chapter 1
1.1 Background
The HIV and AIDS pandemic remains one the most serious development crises in the world (WHO, 2006). Women and children bear a disproportionate share of the burden, and in many settings continue to experience high rates of new HIV infections and of HIV-related illness and death. In 2005 alone, an estimated 540 000 children were newly infected with HIV, with about 90% of these infections occurring in sub-Saharan Africa (UNAIDS, 2006) .UNAIDS estimates that approximately 370 000 children were infected with HIV in 2007[1]. More than 90% of these infections were caused by vertical transmission from mother to infant and approximately 90% occurred in Sub Saharan Africa [1]. In the most heavily affected countries, such as South Africa, Botswana and Zimbabwe, HIV is the underlying reason for more than one third of all deaths among children under the age of five and this is reversing previous gains in child survival. Prevention of mother to child transmission (PMTCT) interventions such as antiretroviral (ARV) prophylaxis have dramatically reduced the risk of vertical transmission from around 40% to less than 5% in some research and pilot settings in Sub Saharan Africa [2]. Governments have committed themselves to reduce the proportion of infants infected with HIV by 50 per cent by 2010, by ensuring that 80% of women have access to PMTCT interventions [3]. However recent data show that overall coverage of ARVs for HIV positive pregnant women is 33% [4] and there is poor coverage in countries with the greatest number of pregnant women living with HIV such as South Africa (50% coverage, [5]Nigeria (3% coverage[5] and Tanzania (15% coverage)[5].

In Ethiopia According to calibrated single point estimates (2007), the national adult HIV prevalence is reported to be 2.1% (7.7% in urban and 0.9% in rural areas). 977,394 Ethiopians are living with HIV/AIDS (41% males, 59% females); an estimated 75,420 HIV-positive pregnant women are anticipated in 2007. Highest prevalence occurs in the 15-24 age groups and prevalence is higher among females than males in both urban and rural areas. Prevalence appears to have leveled off in urban areas but continues to rise in rural areas, where 85% of the population lives. Annual report of 2007 indicated of the total 28,316 ANC clients, 2.7% had positive Rapid Plasma Regain (RPR) (3.6% urban and 2.0% rural)[6].

Addis Ababa is the capital city of Ethiopia and is also the political, economic, and the cultural, center of the country. Addis Ababa has an estimated total population of 3.2 million. Over 51% of the population is female. In Addis HIV/AIDS is the most challenging problem in terms of social, economical, political, and cultural aspects. Even nowadays it is a common thing to lose someone so close due to this disease. PMTCT Service is available in 51 Public and Private Health facilities, In the past 06 months(July-Dec/2009) 34972 mothers were expected at ANC, but 39548 attended ANC, out of whom 28064 (71%)tested for HIV and 809(2.9%)found positive for HIV[7]. Kality health center is one of this health centers found in akaki kality sub-city, 16km far from Addis Ababa city. Estimated total populations of 192859 from this 183259 are living in the city and the rest are living in the rural areas. The number of male living in this city is 94381and females’98478. The sub-industry zone of Addis Ababa city, as result different industries are found. The PMTCT service is started on 2007, according to 2007 data HIV prevalence among pregnant mothers is 11.5% and the prevalence rate on children age less than 15 is 0.95% from this eligible for ART (PMTCT) is 80% [8].

1.2 Introduction
When HIV?AIDS emerged from the shadows two decades ago, few people could predict how the epidemic would evolve, and fewer still could describe with any certainty the best ways of combating it. Now, at the start of a new millennium, we are past the stage of conjecture. We know from experience...
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