title: Rates of HIV-1 superinfection and primary HIV-1 infection are similar in female sex workers in Uganda.
abstract: OBJECTIVE
  To determine and compare the rates of HIV superinfection and primary HIV infection in high-risk female sex workers (FSWs) in Kampala, Uganda.
  
  
  METHODS
  A retrospective analysis of individuals who participated in a clinical cohort study among high-risk FSWs in Kampala, Uganda.
  
  
  METHODS
  Plasma samples from HIV-infected FSWs in Kampala, Uganda were examined with next-generation sequencing of the p24 and gp41 HIV genomic regions for the occurrence of superinfection. Primary HIV incidence was determined from initially HIV-uninfected FSWs from the same cohort, and incidence rate ratios were compared.
  
  
  RESULTS
  The rate of superinfection in these women (7/85; 3.4/100 person-years) was not significantly different from the rate of primary infection in the same population (3.7/100 person-years; incidence rate ratio = 0.91, P = 0.42). Seven women also entered the study dual-infected (16.5% either dual or superinfected). The women with any presence of dual infection were more likely to report sex work as their only source of income (P = 0.05), and trended to be older and more likely to be widowed (P = 0.07).
  
  
  CONCLUSIONS
  In this cohort of FSWs, HIV superinfection occurred at a high rate and was similar to that of primary HIV infection. These results differ from a similar study of high-risk female bar workers in Kenya that found the rate of superinfection to be significantly lower than the rate of primary HIV infection.
authors.affiliation: Laboratory of Immunoregulation, Division of Intramural Research, NIAID, NIH, Bethesda, USA.|Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Redd
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Deogratius
authors.initials: D
authors.lastname: Ssemwanga
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Judith
authors.initials: J
authors.lastname: Vandepitte
authors.affiliation: Laboratory of Immunoregulation, Division of Intramural Research, NIAID, NIH, Bethesda, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Wendel
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Nicaise
authors.initials: N
authors.lastname: Ndembi
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Justine
authors.initials: J
authors.lastname: Bukenya
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Susan
authors.initials: S
authors.lastname: Nakubulwa
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.|London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Heiner
authors.initials: H
authors.lastname: Grosskurth
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Chris M
authors.initials: CM
authors.lastname: Parry
authors.affiliation: Genomics Unit, Research Technologies Branch, Rocky Mountain Laboratories, Division of Intramural Research, NIAID, NIH, Hamilton MT, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Martens
authors.affiliation: Genomics Unit, Research Technologies Branch, Rocky Mountain Laboratories, Division of Intramural Research, NIAID, NIH, Hamilton MT, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bruno
authors.affiliation: Genomics Unit, Research Technologies Branch, Rocky Mountain Laboratories, Division of Intramural Research, NIAID, NIH, Hamilton MT, USA.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Porcella
authors.affiliation: Laboratory of Immunoregulation, Division of Intramural Research, NIAID, NIH, Bethesda, USA.|Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.affiliation: Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Pontiano
authors.initials: P
authors.lastname: Kaleebu
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D015994:Incidence; D012189:Retrospective Studies; D060386:Sex Workers / Q000706:statistics & numerical data*; D012747:Sexual Partners; D015163:Superinfection / Q000453:epidemiology / Q000276:immunology; D014454:Uganda / Q000453:epidemiology; D019562:Viral Load