Temporal Trends in HIV Incidence Among Pregnant Women Attending Antenatal Care Clinics between 1995 and 2003 in Addis Ababa

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Addis Ababa University


HIV infection is routinely diagnosed by various immunoassays that detect the presence of anti- HIV antibodies. But these methods do not distinguish recent from established infections. The previously devised method called Ig G-capture BED-EIA (Subtype B, E, D, Enzyme Immuno Assay) is used to distinguish new from established infection based on standardized optical density values, which is a measure of antibody titer in the serum using cross-sectional specimen. The objective of this study was to identify recent HIV-1 infection using STARHS assay and estimate HIV-1 incidence among pregnant women attending antenatal care clinics in Addis Ababa and to compare the performance of 'in -house' incidence assay kit with commercial assay using 1078 cross-sectional samples collected from pregnant women attending Antenatal Care Clinics (ANC) based on Standardized Optical Density (OD-n) values. Larger percentage of recent infection was observed among women attending the inner city health centers as compared to the outer city health centers and among women aged 1 5 - 1 9 years. A decline in HIV incidence was observed in recent years among women of young age groups attending the inner city health centers. Significant correlation was observed between the two assays. There were 84 common samples which had an OD-n value of less than 0.8 and 954 samples with standardized optical density of greater or equal to 0.8 when tested by both commercial and house -made kits. But forty samples (3.7%) had discrepant results. An agreement was also observed between the OD-n values of the two assays, with a correlation coefficient (r) of 0.76.