Determinants of Prevalent HIV Infection and Late HIV Diagnosis among Young Women with Two or More Sexual Partners in Beira, Mozambique

BACKGROUND The prevalence and determinants of HIV and late diagnosis of HIV in young women in Beira, Mozambique, were estimated in preparation for HIV prevention trials. METHODS An HIV prevalence survey was conducted between December 2009 and October 2012 among 1,018 women aged 18-35 with two or more sexual partners in the last month. Participants were recruited in places thought by recruitment officers to be frequented by women at higher-risk, such as kiosks, markets, night schools, and bars. Women attended the research center and underwent a face-to-face interview, HIV counseling and testing, pregnancy testing, and blood sample collection. RESULTS HIV prevalence was 32.6% (95% confidence interval (CI) 29.7%-35.5%). Factors associated with being HIV infected in the multivariable analysis were older age (p<0.001), lower educational level (p<0.001), self-reported genital symptoms in the last 3 months (adjusted odds ratio (aOR) = 1.4; CI 1.1-2.0), more than one lifetime HIV test (aOR = 0.4; CI 0.3-0.6), and not knowing whether the primary partner has ever been tested for HIV (aOR = 1.7; CI 1.1-2.5). About a third (32.3%) of participants who tested HIV-positive had a CD4 lymphocyte count of <350 cells/µl at diagnosis. Factors associated with late diagnosis in multivariable analyses were: not knowing whether the primary partner has ever been tested for HIV (aOR = 2.2; CI 1.1-4.2) and having had a gynecological pathology in the last year (aOR = 3.7; CI 1.2-12.0). CONCLUSIONS HIV prevalence and late diagnosis of HIV infection were high in our study population of young women with sexual risk behavior in Beira, Mozambique. HIV prevention programs should be strengthened, health care providers should be sensitized, and regular HIV testing should be encouraged to enroll people living with HIV into care and treatment programs sooner.