HIV incidence among non-pregnant women living in selected rural, semi-rural and urban areas in KwaZulu-Natal, South Africa.

The province of KwaZulu-Natal has the highest prevalence of HIV in South Africa, particularly among young women. In order to more closely examine the HIV prevalence and incidence in non-pregnant women from rural, semi-rural and urban areas, data from 5,753 women screened for enrolment into three HIV prevention studies were combined and analysed. The prevalence of HIV infection was 43% at screening. HIV incidence among the 2,523 enrolled HIV-negative women was determined every quarter, and sexual behaviour and socio-demographic data were collected as per respective protocols. During follow-up, 211 women seroconverted (6.6/100 women years). Multivariate analysis found that seroconversion rates were highest among women who were ≤24 years old, single and not cohabiting, and who had incident sexually transmitted infections. The epidemic in KwaZulu-Natal calls for targeted HIV prevention interventions among those at highest risk of acquiring or transmitting infection.