Objective: To monitor HIV-1 and HIV-2 trends in The Gambia, West Africa.
Methods: In 1993–1995 a nationwide survey among 29 670 pregnant women attending
eight antenatal clinics estimated the seroprevalence of HIV-1 at 0.6%, and of HIV-
2 at 1.1%. Five years later, sentinel surveillance in pregnant women was established,
using unlinked anonymous testing in four clinics. A dried blood spot on filter paper
was obtained and tested for HIV antibodies.
Results: Between May 2000 and August 2001, 8054 analysable samples were
collected at four sites. The prevalence of HIV-1 rose sharply in one rural area from 0.6
to 3.0% (P , 0.0001), but the increase was small and non-significant in two other
rural sites and in the urban site. The prevalence of HIV-2 did not change significantly
at any of the sites. The overall prevalence of HIV-1 was 1.0% [95% confidence interval
(CI) 0.8–1.3%], and of HIV-2 0.8% (CI 0.6–1.0%). Site, nationality and higher age
were significantly associated with HIV-1 infection, and higher parity and site were
significantly associated with HIV-2 infection.
Conclusion: Fifteen years after the first case of HIV-1 was described in The Gambia,
the epidemic is still at a low level. There is heterogeneity within the country, with one
rural area experiencing a fivefold increase in 6 years. The prevalence of HIV-2 in The
Gambia is stable