Higher HIV-1 incidence and genetic complexity along main roads in Rakai District, Uganda.
OBJECTIVE
To determine the association between the incidence of HIV-1 infection and the genetic complexity of HIV-1 strains in 2 geographic strata within Rakai District, Uganda.


METHODS
Study volunteers with recent HIV-1 infections during the period 1997 through 2003 were recruited from 10 communities that were geographically stratified as a main road trading center (n = 5) or a secondary road trading village (n = 5). Cryopreserved plasma was available from 384 volunteers and was the source of viral RNA for genotyping by the multiregion hybridization assay. Hazard ratios (HRs) for a single HIV subtype, a recombinant form, or dual infection for gender and geographic strata were obtained using Cox proportional hazards analysis.


RESULTS
The HIV-1 incidence rate during the period 1999 through 2002 was 1.3 per 100 person-years (PYs) in the trading centers and 1.1 per 100 PYs in the trading villages. The HR for infection with an HIV-1 recombinant strain in trading centers relative to trading villages was 2.3 (95% confidence interval [CI]: 1.0 to 6.7). Among those who changed residence between village strata, the HR for a recombinant HIV-1 infection was 8.1 (95% CI: 0.4 to 47.7).


CONCLUSIONS
HIV-1 incidence and genetic complexity are associated with geographic strata and population mobility in Rakai District and are important variables to be considered in planning and recruitment for vaccine trials.
Arroyo
Miguel A
MA
US Military HIV Research Program (USMHRP), Division of Retrovirology, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
Sateren
Warren B
WB
Serwadda
David
D
Gray
Ronald H
RH
Wawer
Maria J
MJ
Sewankambo
Nelson K
NK
Kiwanuka
Noah
N
Kigozi
Godfrey
G
Wabwire-Mangen
Fred
F
Eller
Michael
M
Eller
Leigh Anne
LA
Birx
Deborah L
DL
Robb
Merlin L
ML
McCutchan
Francine E
FE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D014644:Genetic Variation; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000145:classification* / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D015999:Multivariate Analysis; D011995:Recombination, Genetic; D012044:Regression Analysis; D014454:Uganda / Q000453:epidemiology