High HIV-1 prevalence, risk behaviours, and willingness to participate in HIV vaccine trials in fishing communities on Lake Victoria, Uganda
High HIV-1 prevalence, risk behaviours, and willingness to participate in HIV vaccine trials in fishing communities on Lake Victoria, Uganda
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DOI：
10.7448/ias.16.1.18621
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发表时间：
2013-07-22
影响因子：
6
通讯作者：
Sewankambo, Nelson K.
中科院分区：
文献类型：
--
作者：
Kiwanuka, Noah;Ssetaala, Ali;Sewankambo, Nelson K.
简介：撒哈拉以南非洲的艾滋病毒流行是普遍的，但在这些流行病中存在高风险亚组。最近在乌干达民间社区进行的一项研究表明，艾滋病毒流行率（28.8%）和发病率（4.9/100人-年）很高。然而，这些研究结果可能无法反映FFC的人口范围内的艾滋病毒感染率，因为研究人群被选为高危behaviors.Methods：2011年9月至2013年3月，我们进行了一项以社区为基础的队列研究，以确定人口代表性的艾滋病毒感染率和参与意愿（WTP）在假设的疫苗试验之间FFC，乌干达。在基线（2011年9月至2012年1月），在8个渔业社区（一个湖岸和7个岛屿）进行了家庭普查，之后从5360人中随机抽取了2200名18 - 49岁的参与者。访谈管理的问卷调查数据收集艾滋病毒的风险行为和支付意愿，静脉血收集艾滋病毒检测使用快速艾滋病毒检测与酶联免疫吸附试验（EIA）确认。调整后的患病率比例比（adj.PPRs）的艾滋病毒prevalence. Results的确定使用log-binomial回归models.Results：总体基线艾滋病毒感染率为26.7%，女性高于男性（32.6%比20.8%，p < 0.0001）。渔民（22.4%）的患病率低于家庭主妇（32.1%）、农民（33.1%）和酒吧/旅馆/餐馆工作人员（37%）。妇女艾滋病毒的调整后PPR高于男子（调整PPR = 1.50，95%; 1.20，1.87）和30 - 39岁的受试者（调整PPR = 1.40，95%; 1.10，1.79）和40 - 49岁（调整PPR = 1.41，95%; 1.04，1.92）与18 - 24岁人群相比。与艾滋病毒流行有关的其他因素包括教育程度低、以前的婚姻、一夫多妻制婚姻、性行为前饮酒和吸食大麻。假设疫苗试验中的支付意愿为89.3%，男性高于女性（91.2%对87.3%，p = 0.004）和岛屿社区相比，湖滨的（90.4%对85.8%，p = 0.004）。结论：艾滋病毒的流行率在一般的乌干达渔民人口是类似的观察到的“高风险”的渔民。FFC非常愿意参与未来的HIV疫苗试验。
Introduction: HIV epidemics in sub-Saharan Africa are generalized, but high-risk subgroups exist within these epidemics. A recent study among fisher-folk communities (FFC) in Uganda showed high HIV prevalence (28.8%) and incidence (4.9/100 person-years). However, those findings may not reflect population-wide HIV rates in FFC since the study population was selected for high-risk behaviour.Methods: Between September 2011 and March 2013, we conducted a community-based cohort study to determine the population representative HIV rates and willingness to participate (WTP) in hypothetical vaccine trials among FFC, Uganda. At baseline (September 2011 - January 2012), a household enumeration census was done in eight fishing communities (one lakeshore and seven islands), after which a random sample of 2200 participants aged 18 - 49 years was selected from 5360 individuals. Interviewer-administered questionnaire data were collected on HIV risk behaviours and WTP, and venous blood was collected for HIV testing using rapid HIV tests with enzyme-linked immunosorbent assay (EIA) confirmation. Adjusted prevalence proportion ratios (adj.PPRs) of HIV prevalence were determined using log-binomial regression models.Results: Overall baseline HIV prevalence was 26.7% and was higher in women than men (32.6% vs. 20.8%, p < 0.0001). Prevalence was lower among fishermen (22.4%) than housewives (32.1%), farmers (33.1%) and bar/lodge/restaurant workers (37%). The adj.PPR of HIV was higher among women than men (adj.PPR = 1.50, 95%; 1.20, 1.87) and participants aged 30 - 39 years (adj.PPR = 1.40, 95%; 1.10, 1.79) and 40 - 49 years (adj.PPR = 1.41, 95%; 1.04, 1.92) compared to those aged 18 - 24 years. Other factors associated with HIV prevalence included low education, previous marriage, polygamous marriage, alcohol and marijuana use before sex. WTP in hypothetical vaccine trials was 89.3% and was higher in men than women (91.2% vs. 87.3%, p = 0.004) and among island communities compared to lakeshore ones (90.4% vs. 85.8%, p = 0.004).Conclusions: The HIV prevalence in the general fisher-folk population in Uganda is similar to that observed in the "high-risk'' fisher folk. FFC have very high levels of willingness to participate in future HIV vaccine trials.