title: HIV incidence and factors associated with seroconversion in a rural community home based counseling and testing program in Eastern Uganda.
abstract: We estimated HIV incidence and identified risk factors for seroconversion following a rural community home based HIV counseling and testing program in Uganda. We analyzed data from two rounds of testing at least a year apart. Of 19,401 initially seronegative participants, 106 seroconverted in Round 2. Overall HIV incidence was 0.55 per 100 person years (95 % CI: 0.45 -0.66) with no gender difference. Among men, being widowed or divorced (aRR 4.4), and having HIV related symptoms (aRR 11.5) were associated with seroconversion; having primary level education (aRR 0.2) was protective. Among women, being aged 35-59 years (aRR 2.3) and having HIV related symptoms (aRR 9.2) were associated with seroconversion; having couples' posttest counseling in Round 1 (aRR 0.4) was protective. HIV incidence is lower than estimates from elsewhere in Uganda. Nevertheless, focused prevention programs are still needed, targeting previously married men and older women, and including couples' counseling.
authors.affiliation: Department of Health Policy, Planning and Management, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda, alokiria@yahoo.com.
authors.forename: Alfred G
authors.initials: AG
authors.lastname: Okiria
authors.forename: O
authors.initials: O
authors.lastname: Okui
authors.forename: M
authors.initials: M
authors.lastname: Dutki
authors.forename: R
authors.initials: R
authors.lastname: Baryamutuma
authors.forename: C K
authors.initials: CK
authors.lastname: Nuwagaba
authors.forename: E
authors.initials: E
authors.lastname: Kansiime
authors.forename: G
authors.initials: G
authors.lastname: Ojamuge
authors.forename: J
authors.initials: J
authors.lastname: Mugweri
authors.forename: J
authors.initials: J
authors.lastname: Fleuret
authors.forename: R
authors.initials: R
authors.lastname: King
authors.forename: W
authors.initials: W
authors.lastname: Bazeyo
authors.forename: C
authors.initials: C
authors.lastname: Lindan
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology; D006792:House Calls; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult