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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Longitudinal population-level HIV epidemiologic and genomic surveillance highlights growing gender disparity of HIV transmission in Uganda
Nature Microbiology, Year 2023
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Description
HIV incidence in eastern and southern Africa has historically been concentrated among girls and women aged 15–24 years. As new cases decline with HIV interventions, population-level infection dynamics may shift by age and gender. Here, we integrated population-based surveillance of 38,749 participants in the Rakai Community Cohort Study and longitudinal deep-sequence viral phylogenetics to assess how HIV incidence and population groups driving transmission have changed from 2003 to 2018 in Uganda. We observed 1,117 individuals in the incidence cohort and 1,978 individuals in the transmission cohort. HIV viral suppression increased more rapidly in women than men, however incidence declined more slowly in women than men. We found that age-specific transmission flows shifted: whereas HIV transmission to girls and women (aged 15–24 years) from older men declined by about one-third, transmission to women (aged 25–34 years) from men that were 0–6 years older increased by half in 2003 to 2018. Based on changes in transmission flows, we estimated that closing the gender gap in viral suppression could have reduced HIV incidence in women by half in 2018. This study suggests that HIV programmes to increase HIV suppression in men are critical to reduce incidence in women, close gender gaps in infection burden and improve men’s health in Africa. © 2023, The Author(s).
Authors & Co-Authors
Monod, Mélodie
United Kingdom, London
Imperial College London
Galiwango, Ronald Moses
Uganda, Kalisizo
Rakai Health Sciences Program
Ssekubugu, Robert
Uganda, Kalisizo
Rakai Health Sciences Program
Chen, Yu
United Kingdom, London
Imperial College London
Xi, Xiaoyue
United Kingdom, London
Imperial College London
Kankaka, Edward Nelson
United States, Baltimore
Johns Hopkins School of Medicine
Uganda, Kalisizo
Rakai Health Sciences Program
Ssempijja, Victor
United States, Reston
Leidos Inc.
Uganda, Kalisizo
Rakai Health Sciences Program
Abeler-Dörner, Lucie
United Kingdom, Oxford
University of Oxford
Akullian, Adam N.
Unknown Affiliation
Blenkinsop, Alexandra
United Kingdom, London
Imperial College London
Bonsall, David G.
United Kingdom, Oxford
The Wellcome Centre for Human Genetics
United Kingdom, Oxford
University of Oxford
Chang, Larry William
Uganda, Kalisizo
Rakai Health Sciences Program
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Fraser, Christophe
United Kingdom, Oxford
University of Oxford
Golubchik, Tanya
United Kingdom, Oxford
University of Oxford
Australia, Sydney
The University of Sydney
Gray, Ronald H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Jackson, Jade C.
United States, Baltimore
Johns Hopkins School of Medicine
Kigozi, Godfrey G.
Uganda, Kalisizo
Rakai Health Sciences Program
Laeyendecker, Oliver B.
United States, Bethesda
National Institutes of Health Nih
United States, Baltimore
Johns Hopkins School of Medicine
Mills, Lisa A.
United States, Atlanta
Centers for Disease Control and Prevention
Quinn, Thomas Charles
United States, Baltimore
Johns Hopkins School of Medicine
United States, Bethesda
National Institutes of Health Nih
Reynolds, Steven James
Uganda, Kalisizo
Rakai Health Sciences Program
United States, Bethesda
National Institutes of Health Nih
United States, Baltimore
Johns Hopkins School of Medicine
Santelli, John S.
United States, New York
Mailman School of Public Health
Sewankambo, Nelson K.
Uganda, Kampala
Makerere University College of Health Sciences
Spencer, Simon E.F.
United Kingdom, Coventry
University of Warwick
Ssekasanvu, Joseph
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Wawer, Maria J.
Uganda, Kalisizo
Rakai Health Sciences Program
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Serwadda, David Musoke
Uganda, Kalisizo
Rakai Health Sciences Program
Uganda, Kampala
Makerere University College of Health Sciences
Godfrey-Faussett, P. D.
United Kingdom, London
London School of Hygiene & Tropical Medicine
Kagaayi, Joseph
Uganda, Kalisizo
Rakai Health Sciences Program
Grabowski, Mary Kate
Uganda, Kalisizo
Rakai Health Sciences Program
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
United States, Baltimore
Johns Hopkins School of Medicine
Ratmann, Oliver
United Kingdom, London
Imperial College London
Statistics
Citations: 1
Authors: 31
Affiliations: 14
Identifiers
Doi:
10.1038/s41564-023-01530-8
ISSN:
20585276
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda
Participants Gender
Male
Female