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Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

ABSTRACT: Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these areas, and the association between demographic and behavioral characteristics and risk of HIV infection.Data on a total of 2797 pregnant women in Xichang and 3983 pregnant women in Zhaojue and Butuo was collected for the period 2009 to 2015. There was a fluctuating HIV prevalence among pregnant women of Xichang, with a rate of 0.75% in 2015 (?2trend = 2.27, P = 0.13). HIV prevalence among pregnant women of Zhaojue and Butuo was consistently high, varying between 3.4% (9/267, 2011) and 10.3% (82/796, 2012) over the period of 2010 to 2015 (?2trend = 0.12, P = 0.73). In Xichang, we found that Yi ethnicity (OR = 11.37, 95% CI = 2.92-44.25) and a husband who used drugs (OR = 32.13, 95% CI = 5.33-193.67) were significantly associated with HIV risk in pregnant women. For Zhaojue and Butuo, we observed that pregnant women had a higher risk of HIV infection when they were over 30 years old (OR = 1.72, 95% CI = 1.17-2.52), when they had a higher number of previous births, when their husbands had a history of migrating for work (OR = 1.56, 95% CI = 1.16-2.08), and when they had a history of other sexually transmitted infections (OR = 2.19, 95% CI = 1.16-2.08). Compared to those with a primary school education or below, pregnant women with a secondary or high school education level had a lower risk of HIV infection (OR = 0.28, 95% CI = 0.09-0.89).Our results indicate that there is a serious HIV epidemic among pregnant Yi women, especially for those with less education, more past births, or a husband with a history of out-migrating for work or STD infection.

SUBMITTER: Yang S

PROVIDER: S-EPMC5589085 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

Yang Shujuan S Yang Chao C Liao Qiang Q Zhai Wenwen W Yu Gang G Xiao Lin L Wang Qixing Q Gong Yuhan Y Zhang Suhua S Yao Yongna Y Wang Ke K Wang Ju J Bian Shaochao S Liu Qian Q

PloS one 20170907 9

<h4>Background</h4>Yi people make up about 50% of the population in Liangshan Prefecture, Sichuan Province, China, but accounted for 88.07% of new HIV cases in the prefecture from 2011 to 2013. This study evaluated HIV prevalence in pregnant women of Liangshan Prefecture using HIV sentinel surveillance (HSS) data over the period of 2009 to 2015.<h4>Methods</h4>Xichang, Zhaojue County, and Butuo County were selected as HSS sites. We investigated the temporal trends in HIV prevalence in these area ...[more]

PMID: 28880917

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Project description:BackgroundContinuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas.MethodsLiangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected.ResultsIn 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women's. The former severely impoverished counties' age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years).ConclusionsTaking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad.

Project description:BACKGROUND:Due to historical perceptions of Liangshan Yi Autonomous Prefecture (Sichuan Province, China) as being a violent place, and due to its rugged terrain, cultural differences, and relative inaccessibility, few researchers have conducted in-depth ethnobotanical investigations in Liangshan. But wild edible plants (WEPs) are widely consumed by the Yi people of Liangshan, and their associated ethnobotanical knowledge remains relatively unknown, especially outside of China. This study aimed to (1) investigate the WEPs used by the Liangshan Yi, (2) document the traditional knowledge held about these plants, (3) analyze their special preparation methods and consumption habits, and (4) identify species with important cultural significance to the Liangshan Yi. METHODS:During 2016-2017, 396 Yi individuals were interviewed in 1 county-level city and 6 counties across Liangshan. Prior informed consent was obtained, and multiple ethnographic methods were utilized, including direct observation, semi-structured interviews, key informant interviews, informal discussions, and field visits. Market surveys were conducted in April, July, and August 2017 by interviewing 38 Yi merchants selling WEPs in 6 Liangshan traditional markets. We collected information about the parts consumed, preparation methods, consumption habits, growth pattern of species, collection months, market prices, and other uses of WEPs. Use values (UVs) were calculated to analyze the relative cultural importance of each WEP. RESULTS:In total, 105 plant species belonging to 97 genera and 62 families were recorded. Rosaceae was the family with the largest number of species (14), and herbs (58 species) were the dominant growth form reported. Fruits (34 species), roots (21 species), and tender shoots (20 species) were the primary plant parts used for snacking and cooking. There were 6 main preparation and consumption methods of WEPs reported, ranging from primary food, famine food, snack, spice, culinary coagulant, and medicine, among a few other uses. The Liangshan Yi mainly collect WEPs from March to October, seldom collecting from November to February. There were 35 species of WEPs sold in the markets we visited in Liangshan. The price of medicinal plants was much higher than the price of food and fruits. In total, we documented 49 species of edible medicinal plants in Liangshan, accounting for 44.7% of all WEPs. They can be used for treating 27 medical conditions, including cough, diarrhea, injury, and headaches. The plants with the highest UVs were Berberis jamesiana (1.92), Pyracantha fortuneana (1.87), and Artemisia capillaris (1.44) indicating that these species are the most commonly used and important to the Liangshan Yi's traditional life and culture. CONCLUSIONS:The traditional knowledge of WEPs from the accumulated experience of the Yi people's long period residing in Liangshan reflects the cultural richness of the Yi and the plant diversity of the region. Future research on the nutrition, chemical composition, and bioactivity of the WEPs are needed. Some species with high medicinal value but with sharp wild population decline should be surveyed for resource assessment, conservation, and domestication potential.

Project description:ObjectivesNational population-wide HIV prevalence and incidence trends in sub-Saharan Africa (SSA) are indirectly estimated using HIV prevalence measured among pregnant women attending antenatal clinics (ANC), among other data. We evaluated whether recent HIV prevalence trends among pregnant women are representative of general population trends.DesignSerial population-based household surveys in 13 SSA countries.MethodsWe calculated HIV prevalence trends among all women aged 15-49 years and currently pregnant women between surveys conducted from 2003 to 2008 (period 1) and 2009 to 2012 (period 2). Log-binomial regression was used to test for a difference in prevalence trend between the two groups. Prevalence among pregnant women was age-standardized to represent the age distribution of all women.ResultsPooling data for all countries, HIV prevalence declined among pregnant women from 6.5 [95% confidence interval (CI) 5.3-7.9%] to 5.3% (95% CI 4.2-6.6%) between periods 1 and 2, whereas it remained unchanged among all women at 8.4% (95% CI 8.0-8.9%) in period 1 and 8.3% (95% CI 7.9-8.8%) in period 2. Prevalence declined by 18% (95% CI -9-38%) more in pregnant women than nonpregnant women. Estimates were similar in Western, Eastern, and Southern regions of SSA; none were statistically significant (P>0.05). HIV prevalence decreased significantly among women aged 15-24 years while increasing significantly among women 35-49 years, who represented 29% of women but only 15% of pregnant women. Age-standardization of prevalence in pregnant women did not reconcile the discrepant trends because at older ages prevalence was lower among pregnant women than nonpregnant women.ConclusionAs HIV prevalence in SSA has shifted toward older, less-fertile women, HIV prevalence among pregnant women has declined more rapidly than prevalence in women overall. Interpretation of ANC prevalence data to inform national HIV estimates should account for both age-specific fertility patterns and HIV-related sub-fertility.

Dataset Information

Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

Publications

Analysis of HIV prevalence among pregnant women in Liangshan Prefecture, China, from 2009 to 2015.

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