International Journal of Epidemiology, Vol 24, S15-S20, Copyright © 1995 by International Epidemiological Association
AV Swan, A Nicoll, C McGarrigle, A Noone and ON Gill
Considerable speculation and a recent publication has suggested that much
of the human immunodeficiency virus (HIV-1) infection in the subset of the
UK population represented by women having babies in Metropolitan London is
substantially imported from Africa. Other data are supportive of this
hypothesis. Ades et al. (1992) concluded that the fraction of HIV
seroprevalence, identified in a large London-based study using neonatal
blood from the dried blood spots on Guthrie cards, attributable to mothers
born in Africa was 92.4% with 95% CI: 82-100%. This is an important
observation which requires confirmation. This paper reports on an attempt
to do this with closely similar methodology using the Unlinked Anonymous
Survey (UAS) of HIV-1 seroprevalence in pregnant women attending antenatal
centres, together with data from the Office of Population Censuses and
Surveys (OPCS) on the country of origins of mothers delivering in 1991 at
the 15 London centres included in the UAS. As in Ades' analysis there
appeared to be a strong association between centre prevalences and the
proportions of women of African origin delivering at those centres. This
was consistent with a high fraction of seroprevalence attributable to such
women, but it was also clear that the assumptions required for the
estimation of the attributable fractions were not fully met. Analyses
modified to justify the assumptions produced attributable fraction
estimates ranging from 44% to 96% with lower 95% confidence limits 20% or
less.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
An investigation assessing the fraction of human immunodeficiency virus infection attributable to ethnic group variations in risk
PHLS Statistics Unit, London, UK.
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