OBJECTIVES: To describe the epidemiology of HIV-1 infection among adolescents aged 13-19 years, in rural Rakai district, Uganda. STUDY DESIGN: Baseline survey and 2-year follow-up (1990-1992) of adolescents in a population-based, open rural cohort. METHODS: Annual enumeration and behavioral/serological survey of all consenting adolescents aged 13-19 years at recruitment, residing in 31 randomly selected community clusters. RESULTS: At baseline, of 909 adolescents present in study clusters, 824 (90.6%) provided interview data and serological samples. No adolescents aged 13-14 years were HIV-infected. Among those aged 15-19 years, 1.8% of men and 19.0% of women were HIV-positive. Among young women aged 15-19 years in marital/consensual union, 21.3% were HIV-positive; this rate did not differ significantly from the 29.1% prevalence in those reporting non-permanent relationships; prevalence was significantly lower in women reporting no current relationship (4.3%). After multivariate adjustment, female sex, age 17-19 years, residence in trading centers/trading villages and a history of sexually transmitted disease symptoms remained significantly associated with HIV infection. Seventy-nine per cent of adolescents provided a follow-up serological sample. No young men aged 13-14 years seroconverted during the study; in young women aged 13-14 years, HIV seroincidence was 0.6 per 100 person-years (PY) of observation. Among young men aged 15-19 years, there were 1.1 +/- 0.6 seroconversions per 100 PY of observation prior to age 21 years; among women 15-19 years, the incidence rate was 3.9 +/- 1.0 per 100 PY of observation prior to age 21 years. The mortality rate among HIV-positive adolescents aged 15-19 years, at 3.9 per 100 PY of observation, was 13-fold higher than that among the HIV-uninfected. By 1992, knowledge of sexual transmission was almost universal, the proportions reporting multiple partners had decreased and condom use had increased over baseline. CONCLUSIONS: Adolescents, and young women in particular, are vulnerable to HIV infection. Despite reported behavioral changes, HIV incidence rates remain substantial, and there is a need for innovative HIV preventive measures.
OBJECTIVES: To describe the epidemiology of HIV-1 infection among adolescents aged 13-19 years, in rural Rakai district, Uganda. STUDY DESIGN: Baseline survey and 2-year follow-up (1990-1992) of adolescents in a population-based, open rural cohort. METHODS: Annual enumeration and behavioral/serological survey of all consenting adolescents aged 13-19 years at recruitment, residing in 31 randomly selected community clusters. RESULTS: At baseline, of 909 adolescents present in study clusters, 824 (90.6%) provided interview data and serological samples. No adolescents aged 13-14 years were HIV-infected. Among those aged 15-19 years, 1.8% of men and 19.0% of women were HIV-positive. Among young women aged 15-19 years in marital/consensual union, 21.3% were HIV-positive; this rate did not differ significantly from the 29.1% prevalence in those reporting non-permanent relationships; prevalence was significantly lower in women reporting no current relationship (4.3%). After multivariate adjustment, female sex, age 17-19 years, residence in trading centers/trading villages and a history of sexually transmitted disease symptoms remained significantly associated with HIV infection. Seventy-nine per cent of adolescents provided a follow-up serological sample. No young men aged 13-14 years seroconverted during the study; in young women aged 13-14 years, HIV seroincidence was 0.6 per 100 person-years (PY) of observation. Among young men aged 15-19 years, there were 1.1 +/- 0.6 seroconversions per 100 PY of observation prior to age 21 years; among women 15-19 years, the incidence rate was 3.9 +/- 1.0 per 100 PY of observation prior to age 21 years. The mortality rate among HIV-positive adolescents aged 15-19 years, at 3.9 per 100 PY of observation, was 13-fold higher than that among the HIV-uninfected. By 1992, knowledge of sexual transmission was almost universal, the proportions reporting multiple partners had decreased and condom use had increased over baseline. CONCLUSIONS: Adolescents, and young women in particular, are vulnerable to HIV infection. Despite reported behavioral changes, HIV incidence rates remain substantial, and there is a need for innovative HIV preventive measures.
Authors: Nanlesta A Pilgrim; Saifuddin Ahmed; Ronald H Gray; Joseph Sekasanvu; Tom Lutalo; Fred K Nalugoda; David Serwadda; Maria J Wawer Journal: J Interpers Violence Date: 2013-01-06
Authors: Nanlesta A Pilgrim; Saifuddin Ahmed; Ronald H Gray; Joseph Sekasanvu; Tom Lutalo; Fred Nalugoda; David Serwadda; Maria J Wawer Journal: Int J Adolesc Med Health Date: 2015-08
Authors: Xiangrong Kong; Godfrey Kigozi; Fred Nalugoda; Richard Musoke; Joseph Kagaayi; Carl Latkin; Robert Ssekubugu; Tom Lutalo; Betty Nantume; Iga Boaz; Maria Wawer; David Serwadda; Ronald Gray Journal: Am J Epidemiol Date: 2012-10-24 Impact factor: 4.897
Authors: Mark Lurie; Paul Pronyk; Emily de Moor; Adele Heyer; Guy de Bruyn; Helen Struthers; James McIntyre; Glenda Gray; Edmore Marinda; Kerstin Klipstein-Grobusch; Neil Martinson Journal: J Acquir Immune Defic Syndr Date: 2008-04-01 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: Christine L Mattson; Robert C Bailey; Kawango Agot; J O Ndinya-Achola; Stephen Moses Journal: Sex Transm Dis Date: 2007-10 Impact factor: 2.830
Authors: K K Orroth; E L Korenromp; R G White; J Changalucha; S J de Vlas; R H Gray; P Hughes; A Kamali; A Ojwiya; D Serwadda; M J Wawer; R J Hayes; H Grosskurth Journal: Sex Transm Infect Date: 2003-04 Impact factor: 3.519