Background: In countries with generalized epidemics, national estimates of HIV prevalence levels and trends in the adult population are generally derived indirectly from surveillance of pregnant women attending selected antenatal care (ANC) clinics. ANC data however, come from a subset of the population and may not represent the true population prevalence.
Objective: To compare HIV seroprevalence estimates obtained from ANC sentinel surveillance surveys in Ethiopia, Kenya, Malawi, Tanzania, and Uganda with those from population-based Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS).
Methods: Geographic information system (GIS) methods were used to map sentinel surveillance sites and DHS/AIS survey clusters within a 15 km radius of the ANC surveillance sites. National DHS/AIS HIV prevalence estimates for women were compared with national prevalence estimates from ANC surveillance. DHS/AIS HIV prevalence estimates for women residing within 15 km of ANC sites were compared to those from ANC surveillance. These comparisons were also stratified by current
pregnancy status, experience of recent child birth, and receiving ANC for the last birth.
Results: In four of the five countries, national DHS/AIS estimates of HIV prevalence were lower than the ANC surveillance estimates. Comparing women in the catchment