Kiwanuka Noah, Ssetaala Ali, Nalutaaya Annet, Mpendo Juliet, Wambuzi Matthias, Nanvubya Annet, Sigirenda Simon, Kitandwe Paul Kato, Nielsen Leslie Elizabeth, Balyegisawa Apolo, Kaleebu Pontiano, Nalusiba Josephine, Sewankambo Nelson Kaulukusi
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.
Uganda Virus Research Institute-International AIDS Vaccine Initiate HIV Vaccine Program, Entebbe, Uganda.
PLoS One. 2014 May 27;9(5):e94932. doi: 10.1371/journal.pone.0094932. eCollection 2014.
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.
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.
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).
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.
据报道，乌干达渔民社区中因高危行为而被选中的人群艾滋病毒-1感染率很高。我们评估了普通渔民社区人群中艾滋病毒-1的感染率及相关危险因素，以确定全人群的艾滋病毒感染率。
对2191名年龄在18至49岁之间的参与者进行随机抽样，开展了一项基于社区的队列研究。在基线期和基线期后12个月，收集了社会人口学特征和危险行为（包括性伴侣数量、新伴侣、使用避孕套、饮酒和使用非法药物）的数据。采集静脉血进行艾滋病毒血清学检测。按每100人年的风险计算艾滋病毒感染率，并通过多变量泊松回归估计调整后的发病率比（Adj.IRR）。
12个月时的总体随访率为76.9%（1685/2191），在未感染艾滋病毒的人群以及在社区居住至少1年的人群中显著更高。总体艾滋病毒-1感染率为3.39/100人年（95%置信区间：2.55 - 4.49）。在25至29岁饮酒者中，艾滋病毒感染率为7.67/100人年（95%置信区间：4.62 - 12.7），而在18至24岁饮酒者中为5.67/100人年（95%置信区间：3.14 - 10.2）。相对于30岁及以上人群，25至29岁（调整后发病率比 = 3.36；95%置信区间：1.48 - 7.65）和18至24岁（调整后发病率比 = 2.65；95%置信区间：1.05 - 6.70）的艾滋病毒感染风险更高。与不饮酒者相比，艾滋病毒感染率随饮酒频率增加——偶尔饮酒者（调整后发病率比 = 3.18；95%置信区间：1.18 - 8.57）和经常饮酒者（调整后发病率比 = 4.93；95%置信区间：1.91 - 12.8）。
乌干达维多利亚湖沿岸普通渔民人群中的艾滋病毒-1感染率很高，主要与年轻和饮酒有关。该人群迫切需要艾滋病毒预防和控制策略。
