Medical Research Council/Uganda Virus Research Institute Uganda Research Unit & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2020 Apr 17;15(4):e0231640. doi: 10.1371/journal.pone.0231640. eCollection 2020.
Members of uniformed armed forces are considered to be at high risk for HIV infection and have been proposed as suitable candidates for participation in HIV intervention studies. We report on the feasibility of recruitment and follow up of individuals from the community of the Uganda Police Force (UPF) for an HIV vaccine preparedness study.
HIV-negative volunteers aged 18-49 years, were identified from UPF facilities situated in Kampala and Wakiso districts through community HIV counselling and testing. Potential volunteers were referred to the study clinic for screening, enrolment and quarterly visits for one year. HIV incidence, retention rates were estimated and expressed as cases per 100 person years of observation (PYO). Rate ratios were used to determine factors associated with retention using Poisson regression models.
We screened 560 to enroll 500 volunteers between November 2015 and May 2016. One HIV seroconversion occurred among 431 PYO, for an incidence rate of 0.23/100 PYO (95% confidence interval [CI]: 0.03-1.64). Overall, retention rate was 87% at one year, and this was independently associated with residence duration (compared to <1 year, 1 to 5 years adjusted rate ratio (aRR) = 1.19, 95%CI: 1.00-1.44); and >5 years aRR = 1.34, 95%CI: 0.95-1.37); absence of genital discharge in the last 3 months (aRR = 1.97, 95% CI: 1.38-2.83, absence of genital ulcers (aRR = 1.90, 95%CI: 1.26-2.87, reporting of new sexual partner in the last month (aRR = 0.57, 95%CI: 0.45-0.71, being away from home for more than two nights (aRR = 1.27, 95%CI: 1.04-1.56, compared to those who had not travelled) and absence of knowledge on HIV prevention (aRR = 2.67, 95%CI: 1.62-4.39).
While our study demonstrates the feasibility of recruiting and retaining individuals from the UPF for HIV research, we did observe lower than anticipated HIV incidence, perhaps because individuals at lower risk of HIV infection may have been the first to come forward to participate or participants followed HIV risk reduction measures. Our findings suggest lessons for recruitment of populations at high risk of HIV infection.
军警人员被认为感染艾滋病毒的风险较高，因此被提议作为参与艾滋病毒干预研究的合适人选。我们报告了招募和随访乌干达警察部队（UPF）社区成员进行艾滋病毒疫苗准备研究的可行性。
通过社区艾滋病毒咨询和检测，在坎帕拉和瓦基索地区的 UPF 设施中确定年龄在 18-49 岁之间的艾滋病毒阴性志愿者。有潜力的志愿者被转介到研究诊所进行筛选、入组和每季度随访一年。估计艾滋病毒发病率和保留率，并表示为每 100 人年观察（PYO）的病例数（率）。使用泊松回归模型确定与保留相关的因素。
我们筛选了 560 人，在 2015 年 11 月至 2016 年 5 月期间招募了 500 名志愿者。在 431 人年中发生了 1 例艾滋病毒血清转换，发病率为 0.23/100 人年（95%置信区间 [CI]：0.03-1.64）。总体而言，一年时的保留率为 87%，这与居住时间独立相关（与<1 年相比，1-5 年的调整率比（aRR）= 1.19，95%CI：1.00-1.44；5 年以上 aRR = 1.34，95%CI：0.95-1.37）；过去 3 个月无生殖器分泌物（aRR = 1.97，95%CI：1.38-2.83）；无生殖器溃疡（aRR = 1.90，95%CI：1.26-2.87）；报告过去一个月有新的性伴侣（aRR = 0.57，95%CI：0.45-0.71）；离家超过两晚（aRR = 1.27，95%CI：1.04-1.56，与未外出者相比）；以及缺乏艾滋病毒预防知识（aRR = 2.67，95%CI：1.62-4.39）。
虽然我们的研究表明可以招募和留住 UPF 的个人进行艾滋病毒研究，但我们确实观察到预期的艾滋病毒发病率较低，这可能是因为感染艾滋病毒风险较低的个人可能是最早前来参与的人，或者参与者遵循了艾滋病毒减少风险的措施。我们的研究结果为招募艾滋病毒高风险人群提供了经验教训。
