OBJECTIVE: To define the geographical distribution of HIV infection and the community characteristics associated with HIV prevalence in a rural population of Uganda. DESIGN: Seroprevalence survey and interviews of the population aged 13 years and older in 21 randomly selected clusters. SETTING: Rural population of Rakai district, south west Uganda. SUBJECTS: 1292 adults, of whom 594 men and 698 women gave a blood sample and answered the questionnaire. MAIN OUTCOME MEASURES: HIV status determined by ELISA and western blotting in relation to community characteristics. RESULTS: The weighted seroprevalence of HIV for the district was 12.6% with prevalence by cluster varying from 1.2% to 52.8%. Seroprevalence was highest in main road trading centres (men 26%, women 47%), intermediate in rural trading villages on secondary roads (men 22%, women 29%), and lowest in rural agricultural villages (men 8%, women 9%). For both men and women, multiple regression showed a strong negative association between cluster seroprevalence and the proportion of the population employed in agriculture (beta = -0.677 for men, -0.807 for women). Among women, cluster seroprevalence increased with a higher proportion of the population reporting multiple sex partners (beta = 0.814), external travel (beta = 0.579), and injections (beta = 0.483). CONCLUSIONS: Community characteristics, particularly the proportion of the population in agriculture, are associated with HIV prevalence and can be used for targeting interventions. The seroprevalences of HIV suggest spread of infection from main road trading centres, through intermediate trading villages, to rural agricultural villages.
OBJECTIVE: To define the geographical distribution of HIV infection and the community characteristics associated with HIV prevalence in a rural population of Uganda. DESIGN: Seroprevalence survey and interviews of the population aged 13 years and older in 21 randomly selected clusters. SETTING: Rural population of Rakai district, south west Uganda. SUBJECTS: 1292 adults, of whom 594 men and 698 women gave a blood sample and answered the questionnaire. MAIN OUTCOME MEASURES: HIV status determined by ELISA and western blotting in relation to community characteristics. RESULTS: The weighted seroprevalence of HIV for the district was 12.6% with prevalence by cluster varying from 1.2% to 52.8%. Seroprevalence was highest in main road trading centres (men 26%, women 47%), intermediate in rural trading villages on secondary roads (men 22%, women 29%), and lowest in rural agricultural villages (men 8%, women 9%). For both men and women, multiple regression showed a strong negative association between cluster seroprevalence and the proportion of the population employed in agriculture (beta = -0.677 for men, -0.807 for women). Among women, cluster seroprevalence increased with a higher proportion of the population reporting multiple sex partners (beta = 0.814), external travel (beta = 0.579), and injections (beta = 0.483). CONCLUSIONS: Community characteristics, particularly the proportion of the population in agriculture, are associated with HIV prevalence and can be used for targeting interventions. The seroprevalences of HIV suggest spread of infection from main road trading centres, through intermediate trading villages, to rural agricultural villages.
Entities:
Keywords:
Africa; Africa South Of The Sahara; Biology; Data Analysis; Data Collection; Demographic Factors; Developing Countries; Diseases; Eastern Africa; Economic Factors; English Speaking Africa; Examinations And Diagnoses; Hiv Infections--transmission; Laboratory Examinations And Diagnoses; Measurement; Population; Population Characteristics; Prevalence; Research Methodology; Risk Factors; Rural Population; Socioeconomic Factors; Statistical Regression; Uganda; Viral Diseases
Authors: D Serwadda; R D Mugerwa; N K Sewankambo; A Lwegaba; J W Carswell; G B Kirya; A C Bayley; R G Downing; R S Tedder; S A Clayden; R A Weiss; A G Dalgleish Journal: Lancet Date: 1985-10-19 Impact factor: 79.321
Authors: B N'Galy; R W Ryder; K Bila; K Mwandagalirwa; R L Colebunders; H Francis; J M Mann; T C Quinn Journal: N Engl J Med Date: 1988-10-27 Impact factor: 91.245
Authors: P Piot; F A Plummer; M A Rey; E N Ngugi; C Rouzioux; J O Ndinya-Achola; G Veracauteren; L J D'Costa; M Laga; H Nsanze Journal: J Infect Dis Date: 1987-06 Impact factor: 5.226
Authors: F Denis; F Barin; G Gershy-Damet; J L Rey; M Lhuillier; M Mounier; G Leonard; A Sangare; A Goudeau; S M'Boup Journal: Lancet Date: 1987-02-21 Impact factor: 79.321
Authors: J K Kreiss; D Koech; F A Plummer; K K Holmes; M Lightfoote; P Piot; A R Ronald; J O Ndinya-Achola; L J D'Costa; P Roberts Journal: N Engl J Med Date: 1986-02-13 Impact factor: 91.245
Authors: Ashley C Schuyler; Zoe R Edelstein; Sanyukta Mathur; Joseph Sekasanvu; Fred Nalugoda; Ronald Gray; Maria J Wawer; David M Serwadda; John S Santelli Journal: Glob Public Health Date: 2015-08-27
Authors: J P Riley; G A Pestano; K Hosford; C Francis; J M Xie; P Mugyenyi; P Kataaha; E Katongole-Mbidde; W W Anokbonggo; J Guyden Journal: Arch Virol Date: 1995 Impact factor: 2.574
Authors: John S Santelli; Zoe R Edelstein; Sanyukta Mathur; Ying Wei; Wenfei Zhang; Mark G Orr; Jenny A Higgins; Fred Nalugoda; Ron H Gray; Maria J Wawer; David M Serwadda Journal: J Acquir Immune Defic Syndr Date: 2013-07-01 Impact factor: 3.731
Authors: Nelli Westercamp; Stephen Moses; Kawango Agot; Jeckoniah O Ndinya-Achola; Corette Parker; Kevine O Amolloh; Robert C Bailey Journal: Int J Health Geogr Date: 2010-05-22 Impact factor: 3.918
Authors: Jennifer C Moïsi; Hellen Gatakaa; Abdisalan M Noor; Thomas N Williams; Evasius Bauni; Benjamin Tsofa; Orin S Levine; J Anthony G Scott Journal: BMC Public Health Date: 2010-03-17 Impact factor: 3.295
Authors: Margaret Carrel; Mark Janko; Melchior Kashamuka Mwandagalirwa; Camille Morgan; Franck Fwamba; Jérémie Muwonga; Antoinette K Tshefu; Steven Meshnick; Michael Emch Journal: Health Place Date: 2016-03-11 Impact factor: 4.078
Authors: David Guwatudde; Fred Wabwire-Mangen; Leigh Anne Eller; Michael Eller; Francine McCutchan; Hannah Kibuuka; Monica Millard; Nelson Sewankambo; David Serwadda; Nelson Michael; Merlin Robb Journal: PLoS One Date: 2009-01-07 Impact factor: 3.240