title: Independent effects of reported sexually transmitted infections and sexual behavior on HIV-1 prevalence among adult women, men, and teenagers in rural Uganda.
abstract: 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.
authors.affiliation: Department of Public Health, Institute of Health Sciences, University of Oxford, Oxford, UK. lucy.carpenter@nuf.ox.ac.uk
authors.forename: Lucy M
authors.initials: LM
authors.lastname: Carpenter
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kamali
authors.forename: Mary
authors.initials: M
authors.lastname: Payne
authors.forename: Silvia
authors.initials: S
authors.lastname: Kiwuuwa
authors.forename: Peter
authors.initials: P
authors.lastname: Kintu
authors.forename: Jessica
authors.initials: J
authors.lastname: Nakiyingi
authors.forename: John
authors.initials: J
authors.lastname: Kinsman
authors.forename: Norah
authors.initials: N
authors.lastname: Nalweyiso
authors.forename: Maria A
authors.initials: MA
authors.lastname: Quigley
authors.forename: Jane F
authors.initials: JF
authors.lastname: Kengeya-Kayondo
authors.forename: James A G
authors.initials: JA
authors.lastname: Whitworth
mesh_terms: 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