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BMJ. Nov 23, 1991; 303(6813): 1303–1306.
PMCID: PMC1671439

Dynamics of spread of HIV-I infection in a rural district of Uganda.


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.

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Selected References

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  • N'Galy B, Ryder RW, Bila K, Mwandagalirwa K, Colebunders RL, Francis H, Mann JM, Quinn TC. Human immunodeficiency virus infection among employees in an African hospital. N Engl J Med. 1988 Oct 27;319(17):1123–1127. [PubMed]
  • Kreiss JK, Koech D, Plummer FA, Holmes KK, Lightfoote M, Piot P, Ronald AR, Ndinya-Achola JO, D'Costa LJ, Roberts P, et al. AIDS virus infection in Nairobi prostitutes. Spread of the epidemic to East Africa. N Engl J Med. 1986 Feb 13;314(7):414–418. [PubMed]
  • Piot P, Plummer FA, Rey MA, Ngugi EN, Rouzioux C, Ndinya-Achola JO, Veracauteren G, D'Costa LJ, Laga M, Nsanze H, et al. Retrospective seroepidemiology of AIDS virus infection in Nairobi populations. J Infect Dis. 1987 Jun;155(6):1108–1112. [PubMed]
  • Dolmans WM, van Loon AM, van den Akker R, Mulder DW, Shao JF, Mbena E, Mtey P. Prevalence of HIV-1 antibody among groups of patients and healthy subjects from a rural and urban population in the Mwanza region, Tanzania. AIDS. 1989 May;3(5):297–299. [PubMed]
  • Denis F, Barin F, Gershy-Damet G, Rey JL, Lhuillier M, Mounier M, Leonard G, Sangare A, Goudeau A, M'Boup S, et al. Prevalence of human T-lymphotropic retroviruses type III (HIV) and type IV in Ivory Coast. Lancet. 1987 Feb 21;1(8530):408–411. [PubMed]
  • de Lalla F, Rizzardini G, Santoro D, Galli M. Rapid spread of HIV infection in a rural district in central Africa. AIDS. 1988 Aug;2(4):317–317. [PubMed]
  • Killewo J, Nyamuryekunge K, Sandström A, Bredberg-Rådén U, Wall S, Mhalu F, Biberfeld G. Prevalence of HIV-1 infection in the Kagera region of Tanzania: a population-based study. AIDS. 1990 Nov;4(11):1081–1085. [PubMed]
  • Carswell JW. HIV infection in healthy persons in Uganda. AIDS. 1987 Dec;1(4):223–227. [PubMed]
  • Serwadda D, Mugerwa RD, Sewankambo NK, Lwegaba A, Carswell JW, Kirya GB, Bayley AC, Downing RG, Tedder RS, Clayden SA, et al. Slim disease: a new disease in Uganda and its association with HTLV-III infection. Lancet. 1985 Oct 19;2(8460):849–852. [PubMed]
  • Willcox RR. Venereal diseases in the Pacific Islands. Papua New Guinea. Br J Vener Dis. 1980 Oct;56(5):277–281. [PMC free article] [PubMed]
  • Plorde DS. Sexually transmitted diseases in Ethiopia. Social factors contributing to their spread and implications for developing countries. Br J Vener Dis. 1981 Dec;57(6):357–362. [PMC free article] [PubMed]
  • Carswell JW, Lloyd G, Howells J. Prevalence of HIV-1 in east African lorry drivers. AIDS. 1989 Nov;3(11):759–761. [PubMed]

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