Household Survey of HIV Incidence in Rwanda: A National Observational Cohort Study

October 2017 - Epidemiology

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Nsanzimana, S., Remera, E., Kanter, S., et al. The Lancet HIV (August 2017), pii: S2352-3018(17)30124–8, e-publication ahead of print, doi: 10.1016/S2352-3018(17)30124-8.

This study examined HIV incidence in Rwanda. The authors conducted a prospective HIV incidence survey among women aged 15–49 and men aged 15–59 to understand where new infections are occurring, and among whom. Researchers tested a nationally representative sample at baseline and conducted follow-up HIV tests 12 months later on individuals who initially tested negative. During the study period, 14,691 individuals were tested for HIV, among whom 439 tested positive. HIV prevalence was higher among women and among those living in urban areas. At endline, 35 new individuals tested HIV-positive, resulting in an HIV incidence of 0.27/100 person-years. Incidence was higher in adults aged 46–55; women; those never married, divorced, or widowed; and urban residents. Incidence was also higher among adults aged 36–45 than in those aged 16–25, and among those living in the Western Province. Sexual violence in the past year also significantly increased the risk of HIV infection. The authors concluded that Rwanda's HIV incidence is higher than previously reported, which places the country's large population of young people at risk for contracting HIV. These data provide important information that can be used to plan the HIV response more precisely to help Rwanda meet its targets.

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