Modelling the impact of alternative HIV intervention strategies in rural Uganda.
OBJECTIVE
To assess the likely impact on HIV incidence of increased condom use, a reduction in casual sexual partners, treatment programmes for other sexually transmitted diseases (STD) and combinations of these in rural Uganda.


METHODS
A simulation model for the transmission dynamics of HIV infection and STD was employed, drawing on data from a rural population cohort in South-West Uganda with an HIV prevalence of 9% among adults in 1990.


RESULTS
For the scenario most consistent with data from the study population, 39% of all adult HIV infections were averted, in the 10 years from 1990, when condoms were used consistently and effectively by 50% of men in their contacts with one-off sexual partners (such as bar girls and commercial sex workers). Reducing by 50% the frequency of men's sexual contacts with one-off partners averted 68% of infections. Reducing by 50% the duration of all STD episodes averted 43% of infections. Combining these three interventions averted 82% of all adult infections in the 10 years from 1990.


CONCLUSIONS
A substantial proportion of HIV infections may be averted in general populations through interventions targeted only on less regular sexual partnerships.
Robinson
N J
NJ
INSERM Unit 88, National Hospital of Saint-Maurice, France.
Mulder
D W
DW
Auvert
B
B
Hayes
R J
RJ
D000328:Adult; D000368:Aged; D003198:Computer Simulation; D017280:Condoms; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D014454:Uganda