Relatively low HIV infection rates in rural Uganda, but with high potential for a rise: a cohort study in Kayunga District, Uganda.
Relatively low HIV infection rates in rural Uganda, but with high potential for a rise: a cohort study in Kayunga District, Uganda.
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乌干达农村地区艾滋病毒感染率相对较低，但上升潜力很大：乌干达卡永加区的一项队列研究。
DOI：
10.1371/journal.pone.0004145
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发表时间：
2009
期刊：
影响因子：
3.7
通讯作者：
Kayunga Cohort Research Team
中科院分区：
文献类型：
--
作者：
Guwatudde D;Wabwire-Mangen F;Eller LA;Eller M;McCutchan F;Kibuuka H;Millard M;Sewankambo N;Serwadda D;Michael N;Robb M;Kayunga Cohort Research Team
乌干达很少有研究来确定和量化 HIV-1 感染的决定因素。我们报告了一项基于社区的队列研究的结果，其主要目标是确定 HIV-1 流行率、发病率和这些感染的决定因素等。 2006 年 3 月至 7 月期间，来自乌干达卡永加农村地区年龄 15-49 岁的自愿志愿者被招募。每六个月对参与者进行一次评估。进行了一份收集行为和其他 HIV-1 危险因素信息的调查问卷，并在每次研究访视时采集血样用于实验室分析。 2025 名参与者中的 HIV-1 患病率为 9.9% (95% CI = 8.6%–11.2%)。截至12个月随访结束，已累计1689.7人年，中位随访时间11.97个月。检测到 13 例 HIV-1 病例，年 HIV-1 发病率为 0.77% (95% CI = 0.35–1.19)。 HSV-2 感染患病率为 57%，与 HIV-1 感染患病率密切相关（调整后优势比 = 3.9，95% CI= 2.50–6.17）；以及 HIV-1 感染事件（调整后的比率 (RR) = 8.7，95% CI = 1.11–67.2）。与 HIV 感染相关的最重要的行为特征是过去 6 个月内参与者与他们怀疑/知道与他人发生性关系的人发生性关系的次数；在 10 倍及以上时达到统计学显着性（调整后 RR = 6.3，95% CI = 1.73–23.1）。到 12 个月的随访结束时，259 名参与者 (13%) 失访，13 名参与者 (0.6%) 死亡，2 名参与者 (0.1%) 撤回同意。尽管该社区的 HIV-1 发病率相对较低，但患病率仍然相对较高。由于 HSV-2 感染的高流行率以及与多个伴侣发生性行为的行为特征，HIV-1 发病率有可能增加。
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. 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. 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. 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.
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