Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Risk factors for HIV-1 infection in adults in a rural Ugandan community: a case-control study.
AIDS. 1994 Feb;8(2):253-7. Unique Identifier : AIDSLINE MED/94318210 Malamba SS; Wagner HU; Maude G; Okongo M; Nunn AJ; Kengeya-Kayondo JF; Mulder DW; Medical Research Council (UK) Programme on AIDS in Uganda,; Entebbe.
Abstract:
OBJECTIVE: To study in depth sexual history and sexual behaviour variables as risk factors for HIV-1 infection in a rural Ugandan population. METHODS: Following a socioeconomic and serological survey of a rural population in Masaka District, south-west Uganda, 233 randomly selected HIV-1-positive cases and 233 negative controls matched on age and village of residence, were invited in October 1990 to participate in a case-control study. A total of 132 cases and 161 controls attended for in-depth investigation including an interview about sexual behaviour. RESULTS: The factor most strongly associated with increased risk of infection was a greater number of lifetime sexual partners, with odds ratios (OR) of 2.1 and 4.9 for those reporting 4-10 and 11 or more partners, respectively, compared with those reporting less than four partners. Having only one sexual partner did not provide complete protection, a total of seven (one male, six female) subjects reporting only one sexual partner were HIV-1-positive. Other significant factors were a history of genital ulcers [OR, 2.9; 95% confidence intervals (CI), 1.0-9.1) and not being a Muslim (OR, 5.4; 95% CI, 1.8-16.5) suggesting a possible protective effect of circumcision. There was a suggestion that those who married within the last 7 years (OR, 2.4; 95% CI, 0.9-6.1) and men exposed to menstrual blood (OR, 5.7; 95% CI, 0.7-49.8) were at an increased risk of HIV-1 infection. CONCLUSIONS: These results confirm the predominant role of sexual behaviour in the HIV-1 epidemic. Of particular concern is the observation of HIV-1 infection among those reporting only one partner. Where HIV-1 infection is widely distributed in the general population, risk reduction strategies should, in addition to the promotion of partner reduction, place strong emphasis on safe-sex techniques.
Keywords: Adolescence Adult Aged Blood/MICROBIOLOGY Case-Control Studies Circumcision/STATISTICS & NUMER DATA Comorbidity Ethnic Groups Female Genital Diseases, Female/EPIDEMIOLOGY Genital Diseases, Male/EPIDEMIOLOGY Human HIV Infections/*EPIDEMIOLOGY/TRANSMISSION *HIV-1 Male Marriage/STATISTICS & NUMER DATA Menstruation Middle Age Prostitution/STATISTICS & NUMER DATA Risk Factors Rural Population Sex Behavior/*STATISTICS & NUMER DATA Sexual Partners Sexually Transmitted Diseases/EPIDEMIOLOGY Socioeconomic Factors Support, Non-U.S. Gov't Travel/STATISTICS & NUMER DATA Uganda/EPIDEMIOLOGY Ulcer/EPIDEMIOLOGY JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
