Independent effects of reported sexually transmitted infections and sexual behavior on HIV-1 prevalence among adult women, men, and teenagers in rural Uganda.
OBJECTIVE
To assess whether sexually transmitted infections (STIs) and sexual behavior are independently associated with HIV-1 among adult women, men, and teenagers in rural Uganda.


METHODS
Cross-sectional survey.


METHODS
All adults (13 years and older) residing in 18 communities were invited to participate. HIV status was determined from serum samples and data collected during confidential interview. Independent effects of risk factors for HIV were estimated using adjusted odds ratios (ORs) with 95% confidence intervals (CIs) from logistic regression.


RESULTS
Women reporting genital ulcers in the last 12 months were over twice as likely to be HIV positive after adjustment for sociodemographic factors and number of lifetime sexual partners (OR, 2.5; 95% CI, 1.9-3.4). Equivalent associations were stronger for men (OR, 3.2; 95% CI, 2.2-4.7) but weaker for teenagers (OR, 2.0, 95% CI, 0.5-8.7). Number of lifetime sexual partners was associated ( p <.05) with HIV status for women, men, and teenagers independently of reported genital ulcers. Teenagers reporting casual partners were over four times ( p <.001), and men reporting condom use almost twice ( p <.001), as likely to be HIV positive. Neither history of genital discharge nor other measures of sexual behavior were independently related to HIV status.


CONCLUSIONS
Reported STIs and sexual behavior are independently associated with HIV in rural Uganda. Community-based interventions to reduce HIV should target both and should include teenagers.
Carpenter
Lucy M
LM
Department of Public Health, Institute of Health Sciences, University of Oxford, Oxford, UK. lucy.carpenter@nuf.ox.ac.uk
Kamali
Anatoli
A
Payne
Mary
M
Kiwuuwa
Silvia
S
Kintu
Peter
P
Nakiyingi
Jessica
J
Kinsman
John
J
Nalweyiso
Norah
N
Quigley
Maria A
MA
Kengeya-Kayondo
Jane F
JF
Whitworth
James A G
JA
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000639:trends*; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D014454:Uganda / Q000453:epidemiology