Browsing by Author "Nakawooya, Hadijja"

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    Cell Phones, Sexual Behaviors and HIV Prevalence in Rakai, Uganda: A Cross Sectional Analysis of Longitudinal Data
    (AIDS and Behavior, 2020) Nalugoda, Fred; Kreniske, Philip; Hofer, Sarah; Zhong, Xiaobo; Wei, Ying; Grilo, Stephanie A.; Chen, Ivy; D. Kigozi, Ssebaggala; Kigozi, Godfrey; Lutalo, Tom; Ssekubugu, Robert; Nakawooya, Hadijja; Kagaayi, Joseph; Chang, Larry W.; Wawer, Maria J.; Gray, Ronald H.; Wang, Qianshu; Santelli, John S.
    Cell phones have increased communication and connection across the globe and particularly in sub-Saharan Africa—with potential consequences for the HIV epidemic. We examined the association among ownership of cell phones, sexual behaviors (number of sexual partners, alcohol use before sex, inconsistent condom use), and HIV prevalence. Data were from four rounds (2010–2016) of the Rakai Community Cohort Study (N = 58,275). Sexual behaviors and HIV prevalence were compared between people who owned a cell phone to people who did not own a cell phone. We stratified analysis by younger (15–24 years) and older (25+ years) age groups and by gender. Using logistic regression and after adjusting for sociodemographic characteristics, we found cell phone ownership was independently associated with increased odds of having two or more sexual partners in the past 12 months across age and gender groups (young men AOR 1.67, 95% CI 1.47–1.90; young women AOR 1.28 95% CI 1.08–1.53; older men AOR 1.54 95% CI 1.41–1.69; older women AOR 1.44 95% CI 1.26–1.65). Interestingly, young men who owned cell phones had decreased odds of using condoms inconsistently (AOR 0.66, 95% CI 0.57–0.75). For young women, cell phone ownership was associated with increased odds of using alcohol before sex (AOR 1.38 95% CI 1.17–1.63) and increased odds of inconsistent condom use (AOR 1.40, 95% 1.17–1.67). After adjusting for sociodemographic characteristics, only young women who owned cell phones had increased odds of being HIV positive (AOR 1.27 95% CI 1.07–1.50). This association was not mediated by sexual behaviors (Adjusted for sociodemographic characteristics and sexual behaviors AOR 1.24, 95% CI 1.05–1.46). While cell phone ownership appears to be associated with increased HIV risk for young women, we also see a potential opportunity for future cell phone-based health interventions.
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    Dynamics Of Pre-Exposure (PrEP) Eligibility due to Waxing and Waning of HIV Risk in Rakai, Uganda
    (JAIDS Journal of Acquired Immune Deficiency Syndromes, 2022) Ssempijja, Victor; Ssekubugu, Robert; Kigozi, Godfrey; Nakigozi, Gertrude; Kagaayi, Joseph; Nalugoda, Fred; Nantume, Betty; Batte, James; Kigozi, Grace; Nakawooya, Hadijja; Serwadda, David; Reynolds, Steven J.
    We conducted a retrospective population-based study to describe longitudinal patterns of prevalence, incidence, discontinuation, resumption, and durability of substantial HIV risk behaviors (SHR) for PrEP eligibility.The study was conducted among HIV-negative study participants aged 15-49 years that participated in survey rounds of the Rakai Community Cohort Study between August 2011 and June 2018. SHR was defined based on the Uganda national PrEP eligibility as either reporting sexual intercourse with >1 partner of unknown HIV status, non-marital sex without a condom or having transactional sex. Resumption of SHR meant resuming of SHR after stopping SHR, while persistence of SHR meant SHR on >1 consecutive visit. We used generalized estimation equations (GEE) with log-binomial regression models and robust variance to estimate survey-specific prevalence ratios (PR); GEE with modified Poisson regression models and robust variance to estimate incidence ratios for incidence, discontinuation, and resumption of PrEP eligibility.PrEP use should be tailored to the dynamic nature of PrEP eligibility. Preventive-effective adherence should be adopted for assessment of attrition in PrEP programs.
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    High Rates of Pre-exposure Prophylaxis Eligibility and Associated HIV Incidence in a Population With a Generalized HIV Epidemic in Rakai, Uganda
    (Journal of Acquired Immune Deficiency Syndromes, 2022) Ssempijja, Victor; Nakigozi, Gertrude; Ssekubugu, Robert; Kagaayi, Joseph; Kigozi, Godfrey; Nalugoda, Fred; Nantume, Betty; Batte, James; Kigozi, Grace; Nakawooya, Hadijja; Serwadda, David; Cobelens, Frank; Reynolds, Steven J.
    The utility of using pre-exposure prophylaxis (PrEP) eligibility assessments to identify eligibility in general populations has not been well studied in sub-Saharan Africa. We used the Rakai Community Cohort Study to conduct a cross-sectional analysis to estimate PrEP eligibility and a cohort analysis to estimate HIV incidence associated with PrEP eligibility. Based on Uganda's national PrEP eligibility tool, we defined eligibility as reporting at least one of the following HIV risks in the past 12 months: sexual intercourse with more than one partner of unknown HIV status; nonmarital sex act without a condom; sex engagement in exchange for money, goods, or services; or experiencing genital ulcers. We used log-binomial and modified Poisson models to estimate prevalence ratios for PrEP eligibility and HIV incidence, respectively.