Cango Lyec (Healing the Elephant): HIV incidence in post-conflict Northern Uganda

Simple item page
dc.contributor.authorKatamba, Achilles
dc.contributor.authorOgwang, Martin D.
dc.contributor.authorZamar, David S.
dc.contributor.authorMuyinda, Herbert
dc.contributor.authorOneka, Alex
dc.contributor.authorAtim, Stella
dc.contributor.authorJongbloed, Kate
dc.contributor.authorMalamba, Samuel S.
dc.contributor.authorOdongping, Tonny
dc.contributor.authorFriedman, Anton J.
dc.contributor.authorSpittal, Patricia M.
dc.contributor.authorSewankambo, Nelson K.
dc.contributor.authorSchechter, Martin T.
dc.date.accessioned2023-01-17T19:01:11Z
dc.date.available2023-01-17T19:01:11Z
dc.date.issued2020
dc.description.abstractCivil war in Northern Uganda resulted in widespread atrocities, human rights violations, and death, and caused millions to flee to internally displaced persons camps. War-related traumas combined with difficulties accessing HIV prevention and health services has led to extreme HIV-related vulnerability among conflict-affected people who survived the war. Objectives were to (1) determine HIV incidence among conflict-affected people in Northern Uganda and (2) identify vulnerabilities associated with HIV infection. Methods: The Cango Lyec (Healing the Elephant) Project is a prospective cohort involving conflict-affected populations in three districts in Northern Uganda. In 2011, eight randomly selected communities were mapped, and a census was conducted. Consenting participants aged 13 49 years were followed over three rounds of follow-up. Longitudinal data collected included war-related experiences, sexual vulnerabilities, and sociodemographics. Blood samples were tested for HIV-1 at baseline and each 12-month follow-up. Multivariable Cox proportional hazard models determined factors associated with HIV incidence. Findings: Overall, 1920 baseline HIV-negative participants with at least one follow-up contributed 3877 person-years (py) for analysis. Thirty-nine (23 female, 16 male) participants contracted HIV during follow-up. Age- and gender-standardised HIV incidence rate was 102 per 1000py (95%CI: 72-140). Stratified by sex, the age-adjusted HIV incidence was 110 per 1000py (95%CI: 69-166) among women and 94 per 1000py (95%CI: 53-153) among men. Adjusting for confounders, factors associated with risk of HIV included: having been abducted (HR: 370; 95%CI: 187-734), experiencing 12 war-related traumatic events (HR: 291 95%CI: 128-660), suicide ideation (HR: 283; 95%CI: 100-803), having 2 sexual partners (HR: 468; 95%CI: 136-1605), inconsistent condom use (HR: 675; 95%CI: 249-1829), and self-reported genital ulcers (HR: 439; 95%CI: 204-945). Interpretation: Conflict-affected participants who had experienced abduction and multiple traumas during the war were at greater risk of HIV infection. Trauma-informed HIV prevention and treatment services, and culturally-safe mental health initiatives, are urgent for Northern Ugandaen_US
dc.identifier.citationKatamba, A., Ogwang, M. D., Zamar, D. S., Muyinda, H., Oneka, A., Atim, S., ... & Schechter, M. T. (2020). Cango Lyec (healing the elephant): HIV incidence in post-conflict Northern Uganda. EClinicalMedicine, 23, 100408. https://doi.org/10.1016/j.eclinm.2020.100408en_US
dc.identifier.urihttps://doi.org/10.1016/j.eclinm.2020.100408
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6994
dc.language.isoenen_US
dc.publisherEClinicalMedicineen_US
dc.subjectHIV/AIDSen_US
dc.subjectConflict-affected peopleen_US
dc.subjectHIV incidenceen_US
dc.subjectTraumaen_US
dc.subjectMental healthen_US
dc.titleCango Lyec (Healing the Elephant): HIV incidence in post-conflict Northern Ugandaen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Cango Lyec (Healing the Elephant).pdf
Size:
550.3 KB
Format:
Adobe Portable Document Format
Description:
Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences