HIV prevalence and incidence are no longer falling in southwest Uganda: evidence from a rural population cohort 1989-2005
HIV prevalence and incidence are no longer falling in southwest Uganda: evidence from a rural population cohort 1989-2005
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DOI：
10.1097/qad.0b013e32830a7502
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发表时间：
2008-08-20
期刊：
影响因子：
3.8
通讯作者：
Grosskurth, Heiner
中科院分区：
文献类型：
--
作者：
Shafer, Leigh Anne;Biraro, Samuel;Grosskurth, Heiner
背景：在整个20世纪90年代，HIV-1的流行率和发病率在乌干达呈下降趋势。最近，一些研究人员注意到HIV-1的流行率正在下降。我们研究了16年来乌干达农村人口队列的患病率、发病率和性行为趋势。方法：我们报告了一项前瞻性普通人群队列研究中按调查轮数的患病率和按日历年的发病率。使用logistic回归Wald检验，我们检查了随意性伴侣、避孕套使用和怀孕。我们用生命表来检查初次性行为的年龄。结果：HIV-1感染率从1990/1991年的8.511%下降到1999/2000年的6.2%，之后又上升到2004/2005年的7.7%。发病率（每1000人年有危险）从1990年的7.5下降到1998年的4.1，此后到2004年增加到5.0。2005年的发病率估计值达到2.5的历史最低水平，但2006年的初步估计值显示再次上升。发病率趋势因年龄和性别而异。一些性行为指标显示，近年来的危险行为比1990年代多，而另一些指标则表明，从1990年代开始的危险行为的减少仍在继续。结论：HIV-1患病率在该队列中呈上升趋势。发病率趋于稳定，在某些亚组中有上升的迹象。性行为的改变在多大程度上影响了这些表皮学趋势尚不清楚，但它很可能起了一定作用。为了巩固乌干达在整个20世纪90年代控制艾滋病毒表皮方面取得的成就，需要利用所有已知的战略，重新加强预防艾滋病毒的努力。(C) 2008年威科医疗集团bbb & Lippincott Williams & Wilkins。
Background: Throughout the 1990s, HIV-1 prevalence and incidence were falling in Uganda. Recently, some researchers have noticed that HIV-1 prevalence is I eve I I in g off. We examine prevalence, incidence, and sexual behaviour trends in a rural population cohort in Uganda over 16 years.Methods: We report prevalence by survey round and incidence by calendar year from a prospective general population cohort study. Using logistic regression Wald tests, we examined casual partners, condom Use, and pregnancies. We examined age at sexual debut by means of life tables.Results: HIV-1 prevalence declined from 8.511% in 1990/1991 to 6.2%, in 1999/2000, and thereafter rose to 7.7% in 2004/2005. incidence (per 1000 person-years at risk) fell from 7.5 in 1990 to 4.1 in 1998, and thereafter increased to 5.0 by 2004. The 2005 incidence estimate reached ill all-time low of 2.5, but the preliminary 2006 estimate shows a rise again. Incidence trends varied by age and sex. Some sexual behaviour indicators showed more risky behaviour in recent years compared with the 1990s, whereas others indicated that the reduction in risky behaviour that began in the 1990s continues.Conclusion: HIV-1 prevalence is rising in this cohort. Incidence is stabilizing, and shows signs of increasing among some subgroups. The extent to which changing sexual behaviour has played a role in these epidermiological trends is Unclear, but it is likely to have contributed. To solidify the S that Uganda had throughout the 1990s in controlling the HIV epidermic, the efforts in HIV prevention need to be re-strengthened, using all strategies known. (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.