title: Higher HIV-1 incidence and genetic complexity along main roads in Rakai District, Uganda.
abstract: 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.
authors.affiliation: US Military HIV Research Program (USMHRP), Division of Retrovirology, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Arroyo
authors.forename: Warren B
authors.initials: WB
authors.lastname: Sateren
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Wawer
authors.forename: Nelson K
authors.initials: NK
authors.lastname: Sewankambo
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.forename: Fred
authors.initials: F
authors.lastname: Wabwire-Mangen
authors.forename: Michael
authors.initials: M
authors.lastname: Eller
authors.forename: Leigh Anne
authors.initials: LA
authors.lastname: Eller
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Birx
authors.forename: Merlin L
authors.initials: ML
authors.lastname: Robb
authors.forename: Francine E
authors.initials: FE
authors.lastname: McCutchan
mesh_terms: 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