HIV-1 and HIV-2 in Ghana, west Africa: community surveys compared to surveys of pregnant women.

ABSTRACT

We conducted a population-based serosurvey of HIV-1/2 in 2,410 residents of two urban and two rural areas of southern Ghana, West Africa and compared the results to serosurveys of 1,417 pregnant women. Using conservative criteria, we found the prevalence of HIV-1/2 in community survey adults (> 15 years old) to be 1.5% in women and 1.0% in men. Among pregnant women, the prevalence was 9.3% in one rural area but only 1.0% in other areas. Many samples, especially among the pregnant women were HIV-1 and -2 dual reactive on serology. We attribute the disparity between prevalence in the community survey participants and pregnant women to local socio-economic factors. Women in this area have a tradition of working throughout West Africa as trader/ commercial sex workers. When pregnant or ill, they return to their home villages to be with their families. HIV surveillance programs which rely on pregnant women need to be sure that sampled populations are truly typical of the communities they are intended to represent.

ABSTRACT

PIP HIV prevalence in urban and rural southern Ghana was investigated in a community-based serosurvey of 2410 people conducted in 1989-90 and an analysis of serum samples collected in 1987 from 1330 pregnant women attending antenatal clinics in the Eastern Region. None of the 906 children in the community-based survey was HIV-positive, including 6 born to HIV-infected women. Among the 1329 adults, 5 men (1.0%) and 12 women (1.5%) were infected. Among pregnant women, 100 (7.1%) were HIV-positive. At the four antenatal centers, HIV prevalence ranged from 0.6% to 10.3%. The high HIV prevalence recorded among pregnant women in the Manya-Krobo District (10.3%), a rural area away from major travel routes, likely reflects the tendency for ill women to return home to be cared for by their families. HIV surveillance programs that focus on pregnant women should be aware of this social phenomenon.