Browsing by Author "Li, Chuanjun"

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    Age of male circumcision and risk of prevalent HIV infection in rural Uganda
    (Aids, 1999) Kelly, Robert; Kiwanuka, Noah; Wawer, Maria J.; Serwadda, David; Sewankambo, Nelson; Wabwire-Mangen, Fred; Li, Chuanjun; Konde-Lule, Joseph K.; Lutalo, Tom; Makumbi, Fred; Gray, Ronald H.
    Epidemiological evidence suggests that male circumcision may reduce the risk of sexually transmitted diseases (STD) and possibly HIV infection. Studies of STD clinic attenders have found that circumcised men are less likely to have gonorrhea, syphilis, herpes, candidiasis, and genital ulcer disease (GUD) [1–3]. Age at circumcision has also been reported as a risk factor in penile cancer [4]. Ecological studies report geographic correlations between HIV seroprevalence and the proportion of uncircumcised men in African populations [5,6], but subsequent cross-sectional and prospective studies found an inconsistent association between male circumcision and HIV-1 and HIV-2 infection in men and women [7–9].
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    Education attainment as a predictor of HIV risk in rural Uganda: results from a population-based study
    (International journal of STD & AIDS, 1999) Smith, Jennifer; Nalagoda, Fred; Serwadda, David; Sewankambo, Nelson; Konde-Lule, Joseph; Lutalo, Tom; Li, Chuanjun
    We examined the association between education and prevalent HIV-1 infection in the Rakai district, rural Uganda based on a cross-sectional analysis of a population-based cohort. In 1990, 1397 men and 1705 women aged 13 years and older, were enrolled in 31 randomly selected communities. Strata were comprised of main road trading centres, secondary road trading villages and rural villages. Sociodemographic and behavioural data were obtained by interview and serum for HIV serostatus were obtained in the home. The analysis examines the association between sex-specific prevalent HIV infection and educational attainment, categorized as secondary, primary or none. The odds ratios (ORs) and 95% confidence intervals (95% CIs) of HIV infection were estimated, using no education as the referent group. Higher levels of education were associated with a higher HIV seroprevalence in bivariate analyses (OR 2.7 for primary and 4.1 for secondary education, relative to no education). The strength of the association was diminished but remained statistically significant after multivariate adjustment for sociodemographic and behavioural variables (adjusted OR of HIV infection 1.6 (95% CI: 1.2-2.1)) for primary education and 1.5 (95% CI: 1.0-2.2) for secondary education. Stratified multivariate analyses by place of residence indicated that the association between education and HIV prevalence was statistically significant in the rural villages, but not in the main road trading centres and intermediate trading villages. Educational attainment is a significant predictor of HIV risk in rural Uganda, in part because of risk behaviours and other characteristics among better educated individuals. Preventive interventions need to focus on better educated adults and on school-aged populations.
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    Population-based Study of Fertility in Women with HIV-1 Infection in Uganda
    (The lancet, 1998) Gray, Ronald H.; Serwadda, David; Sewankambo, Nelson; Li, Chuanjun; Wabwire-Mangen, Frederick; Kiwanuka, Noah; Kigozi, Godfrey; Konde-Lule, Joseph; McNairn, Denise
    To assess the effects of HIV-1 and other sexually transmitted infections on pregnancy, we undertook cross-sectional and prospective studies of a rural population in Rakai district, Uganda. 4813 sexually active women aged 15–49 years were surveyed to find out the prevalence of pregnancy by interview and selective urinary human chorionic gonadotropin tests. The incidence of recognised conception and frequency of pregnancy loss were assessed by follow-up. Samples were taken to test for HIV-1 infection, syphilis, and other sexually transmitted diseases. At time of survey, 757 (21·4%) of 3544 women without HIV-1 infection or syphilis were pregnant, compared with 46 (14·6%) of 316 HIV-1-negative women with active syphilis, 117 (14·2%) of 823 HIV-1-positive women with no concurrent syphilis, and 11 (8·5%) of 130 women with both syphilis and HIV-1 infection. The multivariate adjusted odds ratio of pregnancy in HIV-1-infected women was 0·45 (95% Cl 0·35–0·57); the odds of pregnancy were low both in HIV-1-infected women without symptoms (0·49 [0·39–0·62]) and in women with symptoms of HIV-1-associated disease (0·23 [0·11–0·48]). In women with concurrent HIV-1 infection and syphilis the odds ratio was 0·28 (0·14–0·55). The incidence rate of recognised pregnancy during the prospective follow-up study was lower in HIV-1-positive than in HIV-1-negative women (23·5 vs 30·1 per 100 woman-years; adjusted risk ratio 0·73 [0·57–0·93]). Rates of pregnancy loss were higher among HIV-1-infected than uninfected women (18·5 vs 12·2%; odds ratio 1·50 [1·01–2·27]). The prevalence of HIV-1 infection was significantly lower in pregnant than in non-pregnant women (13·9 vs 21·3%). Pregnancy prevalence is greatly reduced in HIV-1-infected women, owing to lower rates of conception and increased rates of pregnancy loss. HIV-1 surveillance confined to pregnant women underestimates the magnitude of the HIV-1 epidemic in the general population.