Relatively Low HIV Infection Rates in Rural Uganda, but with High Potential for a Rise: A Cohort Study in Kayunga District, Uganda
Loading...
Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Few studies have been conducted in Uganda to identify and quantify the determinants of HIV-1 infection. We
report results from a community-based cohort study, whose primary objectives were to determine HIV-1 prevalence,
incidence, and determinants of these infections, among other objectives.
Methodology: Consenting volunteers from the rural district of Kayunga in Uganda aged 15–49 years were enrolled between
March and July 2006. Participants were evaluated every six months. A questionnaire that collected information on behavioral
and other HIV-1 risk factors was administered, and a blood sample obtained for laboratory analysis at each study visit.
Principal Findings: HIV-1 prevalence among the 2025 participants was 9.9% (95% CI = 8.6%–11.2%). By the end of
12 months of follow-up, 1689.7 person-years had been accumulated, with a median follow-up time of 11.97 months.
Thirteen HIV-1 incident cases were detected giving an annual HIV-1 incidence of 0.77% (95% CI = 0.35–1.19). Prevalence of
HSV-2 infection was 57% and was strongly associated with prevalent HIV-1 infection (adjusted Odds Ratio = 3.9, 95%
CI = 2.50–6.17); as well as incident HIV-1 infection (adjusted Rate Ratio (RR) = 8.7, 95% CI = 1.11–67.2). The single most
important behavioral characteristic associated with incident HIV infection was the number of times in the past 6 months, a
participant had sex with person(s) they suspected/knew were having sex with others; attaining statistical significance at 10
times and higher (adjusted RR = 6.3, 95% CI = 1.73–23.1). By the end of 12 months of follow-up, 259 participants (13%) were
lost to follow-up, 13 (0.6%) had died, and 2 (0.1%) had withdrawn consent.
Conclusions: Despite relatively low HIV-1 incidence observed in this community, prevalence remains relatively high. In the
presence of high prevalence of HSV-2 infection and the behavioral characteristic of having sex with more than one partner,
there is potential for increase in HIV-1 incidence.
Description
Keywords
Low HIV Infection Rates, Rural Uganda, Cohort Study, Kayunga District, Uganda
Citation
Guwatudde D, Wabwire-Mangen F, Eller LA, Eller M, McCutchan F, et al. (2009) Relatively Low HIV Infection Rates in Rural Uganda, but with High Potential for a Rise: A Cohort Study in Kayunga District, Uganda. PLoS ONE 4(1): e4145. doi:10.1371/journal.pone.0004145