High HIV Incidence and Socio-Behavioral Risk Patterns in Fishing Communities on the Shores of Lake Victoria, Uganda
High HIV Incidence and Socio-Behavioral Risk Patterns in Fishing Communities on the Shores of Lake Victoria, Uganda
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DOI：
10.1097/olq.0b013e318251555d
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发表时间：
2012-06-01
影响因子：
3.1
通讯作者：
Kaleebu, Pontiano
中科院分区：
文献类型：
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作者：
Seeley, Janet;Nakiyingi-Miiro, Jessica;Kaleebu, Pontiano
背景：我们报告了乌干达维多利亚湖沿岸 5 个渔业社区的艾滋病毒感染及其相关风险因素。 2009 年招募了 1000 名年龄在 13 至 49 岁之间、未感染 HIV 的高危志愿者，并进行了为期 18 个月的随访。方法：在登记和半年访视时，通过结构化问卷收集社会人口统计和危险行为数据，并检测血液样本是否感染 HIV 和梅毒。通过深度访谈，收集了 78 名志愿者的详细生活史。 结果：在 1000 名志愿者中，919 名 (91.9%) 进行了随访，其中 762 名 (76.2%) 达到了研究终点（血清转化或完成 4 次就诊）。 1205.6 人年风险 (PYAR) 中有 59 起事件病例，导致每 100 PYAR 的发病率为 4.9 例（95% CI = 3.8 至 6.3）。艾滋病毒感染率最高的是酒吧工作人员（9.8/100 PYAR [4.7-20.6]）、新教徒（8.6/100 PYAR [5.8-12.7]）、13 至 24 岁人群（7.5/100 PYAR [5.2-11.0]）和新移民（6.6/100 PYAR [5.2-11.0]）。 [4.9-8.9]）。 HIV 感染与年轻（调整后风险比 (aHR) = 2.5 [95% CI = 1.3-4.9]）、最近报告生殖器溃疡/分泌物（aHR = 2.8 [1.6-5.0]）、经常饮酒（aHR = 3.3 [1.6-6.1]）、使用大麻（aHR = 2.9 [1.0-8.0]）、吸烟独立相关吸烟（aHR = 3.6 [1.4-9.3]）和宗教（与天主教徒相比，新教徒的 aHR = 2.7 [1.4-5.3]，穆斯林的 aHR = 2.3 [1.1-4.8]）。结论：这些捕鱼社区的 HIV 感染率较高，这主要是由高危行为造成的。迫切需要针对这一弱势和被忽视的群体开展艾滋病毒预防和研究工作。
Background: We report on HIV acquisition and its associated risk factors in 5 fishing communities on the shores of Lake Victoria in Uganda. A cohort of 1000 HIV-uninfected at-risk volunteers aged 13 to 49 years were recruited in 2009 and followed up for 18 months.Methods: At enrollment and semiannual visits, socio-demographic and risk behavior data were collected through a structured questionnaire and blood samples tested for HIV and syphilis. Detailed life histories were collected from 78 volunteers using in-depth interviews.Results: Of the 1000 volunteers enrolled, 919 (91.9%) were followed up, with 762 (76.2%) reaching the study end points (either seroconverted or completed 4 visits). There were 59 incident cases in 1205.6 person-years at risk (PYAR), resulting in an incidence rate of 4.9 (95% CI = 3.8 to 6.3) per 100 PYAR. The highest HIV incidence rates were among those working in bars (9.8/100 PYAR [4.7-20.6]), protestants (8.6/100 PYAR [5.8-12.7]), those aged 13 to 24 years (7.5/100 PYAR [5.2-11.0]), and new immigrants (6.6/100 PYAR [4.9-8.9]). HIV infection was independently associated with being young (adjusted hazard ratio (aHR) = 2.5 [95% CI = 1.3-4.9]), reporting genital sores/discharge recently (aHR = 2.8 [1.6-5.0]), regular alcohol consumption (aHR = 3.3 [1.6-6.1]), use of marijuana (aHR = 2.9 [1.0-8.0]), cigarette smoking (aHR = 3.6 [1.4-9.3]), and religion (compared with Catholics, Protestants had aHR = 2.7 [1.4-5.3] and Muslims had aHR = 2.3 [1.1-4.8]).Conclusions: These fishing communities experienced high HIV infection, which was mainly explained by high-risk behavior. There is an urgent need to target HIV prevention and research efforts to this vulnerable and neglected group.