Heterogeneity of HIV incidence: a comparative analysis between fishing communities and in a neighbouring rural general population, Uganda, and implications for HIV control.
Heterogeneity of HIV incidence: a comparative analysis between fishing communities and in a neighbouring rural general population, Uganda, and implications for HIV control.
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DOI：
10.1136/sextrans-2015-052179
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发表时间：
2016-09
影响因子：
3.6
通讯作者：
Fast P
中科院分区：
文献类型：
--
作者：
Kamali A;Nsubuga RN;Ruzagira E;Bahemuka U;Asiki G;Price MA;Newton R;Kaleebu P;Fast P
使用2012年1月至2014年12月在捕鱼队列（FC）和邻近农村一般人群队列（GPC）中收集的发病率数据描述乌干达农村的艾滋病毒异质性。在FC中，每3个月入组、随访和检测一次符合条件的18岁以上HIV高危成人。 还收集了人口和性行为数据。对距离FC约47公里的GPC进行了年度调查，并收集了社会人口和行为数据。选择具有与FC相当的风险特征的GPC子集。我们提供了社会人口统计学和风险概况，并计算了分层的HIV发病率。考克斯回归用于评估与HIV发病率相关的因素。FC的总体HIV发病率高于“高危”GPC，分别为6.04和0.56/100人年，率比（RR）为10.83（95%CI 6.11至19.76）。18-24岁、未婚和过去1年内有2个性伴以上者的RR较高，分别为15.44、22.99和19.29。 在FC中，多变量分析中与高发病率相关的因素是在社区的持续时间和无保护性行为。GPC中的因素包括种族、婚姻状况和在社区的持续时间。我们观察到艾滋病毒发病率存在很大的异质性。渔业社区的高发病率大大增加了乌干达的总体艾滋病毒负担，因此迫切需要采取综合预防措施，以实现减少艾滋病毒流行的国家目标。
To describe HIV heterogeneity in rural Uganda using incidence data collected between January 2012 and December 2014 among fishing cohort (FC) and in an adjacent rural general population cohort (GPC). In the FC, eligible HIV high-risk adults aged 18+ years were enrolled, followed and HIV tested every 3 months. Demographic and sexual behaviour data were also collected. The GPC, approximately 47 km away from the FC, was followed through annual surveys, and sociodemographic and behavioural data collected. A subset of GPC with comparable risk profiles to the FC was selected. We presented sociodemographic and risk profiles and also computed stratified HIV incidence. Cox regression was used to assess factors associated with HIV incidence. Overall HIV incidence was higher in the FC than in the ‘high-risk’ GPC, 6.04 and 0.56 per 100 person years at risk, respectively, with a rate ratio (RR) of 10.83 (95% CI 6.11 to 19.76). This was higher among those aged 18–24 years, unmarried and those with more than two sex partners in the past year, RR of 15.44, 22.99 and 19.29, respectively. In the FC, factors associated with high incidence in multivariate analysis were duration in the community and unprotected sex. The factors in the GPC were ethnicity, marital status and duration in the community. We have observed a substantial heterogeneity in HIV incidence. The high incidence in fishing communities is contributing greatly to the overall HIV burden in Uganda, and thus urgent combination prevention efforts are needed towards national goal to reduce HIV epidemic.
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影响因子：
3.7
作者：
Kamali, Anatoli;Price, Matt A.;Gilmour, Jill
通讯作者：
Gilmour, Jill
影响因子：
--
作者：
WAWER, MJ;SERWADDA, D;SEWANKAMBO, NK
通讯作者：
SEWANKAMBO, NK
影响因子：
168.9
作者：
SERWADDA, D;SEWANKAMBO, NK;DALGLEISH, AG
通讯作者：
DALGLEISH, AG
影响因子：
6
作者：
Kiwanuka, Noah;Ssetaala, Ali;Sewankambo, Nelson K.
通讯作者：
Sewankambo, Nelson K.
影响因子：
3.8
作者：
Shafer, Leigh Anne;Biraro, Samuel;Grosskurth, Heiner
通讯作者：
Grosskurth, Heiner