Estimated HIV Trends and Program Effects in Botswana 英文参考文献.docVIP

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Estimated HIV Trends and Program Effects in Botswana 英文参考文献.doc

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EstimatedHIVTrendsandProgramEffectsinBotswana JohnStover1*,BogaFidzani2,3,BathoChrisMolomo2,ThembaMoeti3,GodfreyMusuka3 1FuturesInstitute,Glastonbury,Connecticut,UnitedStatesofAmerica,2NationalAIDSCoordinatingAgency,Gaborone,Botswana,3AfricanComprehensiveHIV/AIDS Partnership,Gaborone,Botswana Abstract Background: This study uses surveillance, survey and program data to estimate past trends and current levels of HIV in Botswanaandtheeffectsoftreatmentandpreventionprograms. Methods/PrincipalFindings:Datafromsentinelsurveillanceatantenatalclinicsandanationalpopulationsurveywereused toestimatethetrendofadultHIVprevalencefrom1980to2007.Usingtheprevalencetrendweestimatedthenumberof new adultinfections, thetransmission frommothers tochildren, theneed fortreatment andtheeffects of antiretroviral therapy(ART)andadultandchilddeaths.Prevalencehasdeclinedslowlyinurbanareassince2000andhasremainedstable in rural areas. National prevalence is estimated at 26% (25–27%) in 2007. About 330,000 (318,000–335,000) people are infectedwithHIVincluding20,000children.Thenumberofnewadultinfectionshasbeenstableforseveralyearsatabout 20,000annually(12,000–26,000).Thenumberofnewchildinfectionshasdeclinedfrom4600in1999toabout890(810–980) today due to nearly complete coverage of an effective program to prevent mother-to-child transmission (PMTCT). The annualnumberofadultdeathshasdeclinedfromapeakofover15,500in2003tounder7400(5000–11,000)todaydueto coverageofARTthatreachesover80%inneed.TheneedforARTwillincreaseby60%by2016. Conclusions: Botswana’s PMTCT and treatment programs have achieved significant results in preventing new child infections and deaths among adults and children. The number of new adult infections continues at a high level. More effectivepreventioneffortsareurgentlyneeded. Citation:StoverJ,FidzaniB,MolomoBC,MoetiT,MusukaG(2008)EstimatedHIVTrendsandProgramEffectsinBotswana.PLoSONE3(11):e3729.doi:10.1371/ journal.pone.0003729 Editor:DouglasF.Nixon,UniversityofCaliforniaSanFranci