title: An assessment of fishing communities around Lake Victoria, Uganda, as potential populations for future HIV vaccine efficacy studies: an observational cohort study.
abstract: BACKGROUND
  An effective HIV vaccine is still elusive. Of the 9 HIV preventive vaccine efficacy trials conducted to-date, only one reported positive results of modest efficacy. More efficacy trials need to be conducted before one or more vaccines are eventually licensed. We assessed the suitability of fishing communities in Uganda for future HIV vaccine efficacy trials.
  
  
  METHODS
  A community-based cohort study was conducted among a random sample of 2191 participants aged 18-49 years. Data were collected on socio-demographic characteristics, HIV risky behaviors, and willingness to participate in future HIV vaccine trials (WTP). Venous blood was collected for HIV serological testing. Retention/follow rates and HIV incidence rates per 100 person years at-risk (pyar) were estimated. Adjusted prevalence proportion ratios (PPRs) of retention and odds ratios (ORs) of lack of WTP were estimated using log-binomial and logistic regression models respectively.
  
  
  RESULTS
  Overall retention rate was 76.9% (1685/2191), highest (89%) among participants who had spent 5+ years in the community and lowest (54.1%) among those with <1 year stay. Significant predictors of retention included tribe/ethnicity, baseline HIV negative status, and longer than 1 year stay in the community. Overall WTP was 89.1% (1953/2191). Lack of WTP was significantly higher among women than men [adj.OR = 1.51 (95% CI, 1.14- 2.00)] and among participants who had stayed in fishing communities for 10 or more years relative to those with less than one year [adj.OR = 1.78 (95% CI, 1.11 - 2.88)]. Overall HIV incidence rate per 100 pyar was 3.39 (95% CI; 2.55 - 4.49). Participants aged 25-29 years had highest incidence rates (4.61 - 7.67/100 pyar) and high retention rates between 78.5 and 83.1%. In a combined analysis of retention and incidence rates participants aged 30+ years had retention rates ~80% but low incidence rates (2.45 - 3.57 per 100 pyar) while those aged 25-29 years had the highest incidence rates (4.61 - 7.67/100 pyar) and retention rates 78.5 - 83.1%.
  
  
  CONCLUSIONS
  There is high HIV incidence, retention and WTP among fishing communities around L. Victoria, Uganda which make these communities appropriate for future HIV prevention efficacy studies including vaccine trials.
authors.affiliation: Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda. nkiwanuka@gmail.com.
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.forename: Juliet
authors.initials: J
authors.lastname: Mpendo
authors.forename: Annet
authors.initials: A
authors.lastname: Nalutaaya
authors.forename: Matthias
authors.initials: M
authors.lastname: Wambuzi
authors.forename: Annet
authors.initials: A
authors.lastname: Nanvubya
authors.forename: Paul K
authors.initials: PK
authors.lastname: Kitandwe
authors.forename: Enoch
authors.initials: E
authors.lastname: Muyanja
authors.forename: Julius
authors.initials: J
authors.lastname: Ssempiira
authors.forename: Apolo
authors.initials: A
authors.lastname: Balyegisawa
authors.forename: Ali
authors.initials: A
authors.lastname: Ssetaala
mesh_terms: D016915:AIDS Vaccines / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D015331:Cohort Studies; D005260:Female; D005398:Fisheries; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D010352:Patient Dropouts / Q000706:statistics & numerical data; D015995:Prevalence; D012111:Residence Characteristics; D012309:Risk-Taking; D017678:Sex Distribution; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D016915:AIDS Vaccines