Using VCT Data as in Alternative Tool For Trend Analysis and Monitoring of HIV/Aids Epidemic and Its Demographic Impact in Addis Ababa, Ethiopia

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Addis Abeba university


A retrospective quantitative study was carried out from January to June 2006, to know the magnitude and trend of HIV/AIDS epidemic in Addis Ababa using data from the routine VCT services as an alternative data source and thereby to determine its impact on selected demographic variables. Based on the large sample size (481,648 VCT clients in Addis Ababa) taken inference was made to estimate the prevalence of HIV/AIDS for the entire Addis Ababa. Accordingly, the VCT based modeled prevalence curve depicts three epidemic patterns that show a gradual increment at the start of the HIV epidemic followed by a rapid rise to a peak and rapid fall in HIV prevalence with a subsequent slowing down in the pace of the HIV prevalence. In this study, both ANC and VCT modeled prevalence rates showed similar and regular trend from the beginning of the HIV epidemic till the year 1995 where the modeled ANC data showed higher prevalence rates. However, a lower HIV prevalence was noted for the ANC than the VCT modeled data during the years of 1996 through 2002. On the contrary, the ANC modeled prevalence was higher than the VCT prevalence starting from 2004 onwards where a maximum difference of 2.2 percent was observed towards the end of the projection period. This study suggests that VCT modeled HIV prevalence data closely approximate prevalence among all ANC attendees in Addis Ababa setting where very high participation rate exists to the routine VCT services. Based on the two sets of data sources and the corresponding HIV prevalence obtained, the study shows that, in the absence of AIDS, the two major mortality indicators namely: IMR and U5MR decline over the projection period. The presence of HIV/AIDS epidemic, however, slows down this decline, and in fact reverses it in some cases like CDR and LE at birthAlthough ANC based surveillance system provides solid long-term data, the rapid expansion of routine VCT program in an urban setting like Addis Ababa can be considered as an alternative data source to replace or supplement the ANC based surveillance, where a population based sero-prevalence survey is less likely to be conducted at regular intervals to monitor the HIV/AIDS epidemic trend