title: High incidence of HIV-1 infection in a general population of fishing communities around Lake Victoria, Uganda.
abstract: BACKGROUND
  High HIV-1 incidence rates were reported among persons in fisherfolk communities (FFC) in Uganda who were selected for high risk behaviour. We assessed the incidence of HIV-1 and associated risk factors in a general population FFC to determine population-wide HIV rates.
  
  
  METHODS
  A community-based cohort study was conducted among a random sample of 2191 participants aged 18-49 years. At baseline and 12 months post-baseline, data were collected on socio-demographic characteristics and risky behaviors (including number of partners, new partners, condom use, use of alcohol and illicit drug use). Venous blood was collected for HIV serological testing. HIV incidence was calculated per 100 person years at-risk (pyar) and adjusted incidence rate ratios (Adj.IRR) were estimated by multivariable Poisson regression.
  
  
  RESULTS
  Overall follow up at 12 months was 76.9% (1685/2191) and was significantly higher among HIV uninfected persons and those with at least 1 year duration of stay in community. Overall HIV-1 incidence was 3.39/100 pyar (95% CI: 2.55-4.49). Among the 25-29 years who drank alcohol, HIV incidence was 7.67/100 pyar (95% CI;4.62-12.7) while it was 5.67/100 pyar (95% CI;3.14-10.2) for 18-24 year olds who drank alcohol. The risk of HIV infection was higher among 25-29 years (adj.IRR = 3.36; 95% CI: 1.48-7.65) and 18-24 years (adj.IRR = 2.65; 95% CI: 1.05-6.70) relative to 30+ years. Compared to non-drinkers, HIV incidence increased by frequency of alcohol drinking--occasional drinkers (adj.IRR = 3.18; 95% CI: 1.18-8.57) and regular drinkers (adj.IRR = 4.93; 95% CI: 1.91-12.8).
  
  
  CONCLUSIONS
  HIV-1 incidence in general fisherfolk population along L. Victoria, Uganda, is high and is mainly associated with young age and alcohol drinking. HIV prevention and control strategies are urgently needed in this population.
authors.affiliation: Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda; Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Ali
authors.initials: A
authors.lastname: Ssetaala
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Annet
authors.initials: A
authors.lastname: Nalutaaya
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Juliet
authors.initials: J
authors.lastname: Mpendo
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wambuzi
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Annet
authors.initials: A
authors.lastname: Nanvubya
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Simon
authors.initials: S
authors.lastname: Sigirenda
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
authors.forename: Paul Kato
authors.initials: PK
authors.lastname: Kitandwe
authors.affiliation: International AIDS Vaccine Initiative (IAVI), New York, New York, United States of America.
authors.forename: Leslie Elizabeth
authors.initials: LE
authors.lastname: Nielsen
authors.affiliation: International AIDS Vaccine Initiative (IAVI), New York, New York, United States of America.
authors.forename: Apolo
authors.initials: A
authors.lastname: Balyegisawa
authors.affiliation: Medical Research Council/Uganda Virus Research Insitute, Uganda Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Pontiano
authors.initials: P
authors.lastname: Kaleebu
authors.affiliation: Makerere University College of Health Sciences, School of Medicine, Clinical Epidemiology Unit, Kampala, Uganda.
authors.forename: Josephine
authors.initials: J
authors.lastname: Nalusiba
authors.affiliation: Makerere University College of Health Sciences, School of Medicine, Clinical Epidemiology Unit, Kampala, Uganda.
authors.forename: Nelson Kaulukusi
authors.initials: NK
authors.lastname: Sewankambo
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D005398:Fisheries; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D015994:Incidence; D060106:Lakes; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult