DYNAMICS OF SPREAD OF HIV-I INFECTION IN A RURAL DISTRICT OF UGANDA
DYNAMICS OF SPREAD OF HIV-I INFECTION IN A RURAL DISTRICT OF UGANDA
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DOI：
10.1136/bmj.303.6813.1303
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发表时间：
1991-11-23
影响因子：
--
通讯作者：
SEWANKAMBO, NK
中科院分区：
文献类型：
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作者：
WAWER, MJ;SERWADDA, D;SEWANKAMBO, NK
目的-确定乌干达农村人口中HIV感染的地理分布和与HIV流行相关的社区特征。设计-在21个随机选择的群组中对13岁及以上的人口进行血清阳性率调查和访谈。设置-乌干达西南部Rakai区的农村人口。受试者- 1292名成年人，其中594名男性和698名女性提供了血液样本，并回答了questionnaire.Main outcome measures - HIV状况确定的ELISA和蛋白质印迹法在社区feature.Results -加权血清阳性率的艾滋病病毒为12.6%，流行率从1.2%到52.8%不等的集群。主要公路贸易中心的血清阳性率最高（男子26%，妇女47%），中等水平的是位于二级公路上的农村贸易村（男子22%，妇女29%），最低水平的是农村农业村（男子8%，妇女9%）。对男性和女性而言，多重回归显示，聚集性血清阳性率与农业就业人口比例之间存在很强的负相关性（男性β = -0.677，女性β =-0.807）。在妇女中，集群血清阳性率增加了较高比例的人口报告多个性伴侣（β = 0.814），外部旅行（β = 0.579），注射（β = 0.483）。结论-社区特征，特别是人口的比例在农业，与艾滋病毒的流行，可用于有针对性的干预措施。艾滋病毒血清阳性反应表明，感染从主要公路贸易中心，通过中间贸易村，向农村蔓延。
Objective - To define the geographical distribution of HIV infection and the community characteristics associated with HIV prevalence in a rural population of Uganda.Design - Seroprevalence survey and interviews of the population aged 13 years and older in 21 randomly selected clusters.Setting - Rural population of Rakai district, south west Uganda.Subjects - 1292 adults, of whom 594 men and 698 women gave a blood sample and answered the questionnaire.Main outcome measures - HIV status determined by ELISA and western blotting in relation to community characteristics.Results - The weighted seroprevalence of HIV for the district was 12.6% with prevalence by cluster varying from 1.2% to 52.8%. Seroprevalence was highest in main road trading centres (men 26%, women 47%), intermediate in rural trading villages on secondary roads (men 22%, women 29%), and lowest in rural agricultural villages (men 8%, women 9%). For both men and women, multiple regression showed a strong negative association between cluster seroprevalence and the proportion of the population employed in agriculture (beta = -0.677 for men, -0.807 for women). Among women, cluster seroprevalence increased with a higher proportion of the population reporting multiple sex partners (beta = 0.814), external travel (beta = 0.579), and injections (beta = 0.483).Conclusions - Community characteristics, particularly the proportion of the population in agriculture, are associated with HIV prevalence and can be used for targeting interventions. The seroprevalences of HIV suggest spread of infection from main road trading centres, through intermediate trading villages, to rural agricultural villages.