Two-year HIV-1-associated mortality in a Ugandan rural population

The mortality in 15 villages in South-West Uganda was studied in relation to HIV infection. After a population census, serum samples were tested for antibodies to HIV-1. Deaths were ascertained over 2 years. Unequivocal HIV-1 serology results were available for 9389 individuals. The prevalence of infection was 4·8% for all ages and 8·2% for adults (aged 13 or more). 198 deaths were recorded during 15 725 person years of observation. Mortality among seronegative adults was 7 7 per 1000 and among seropositive adults 115·9 per 1000. The excess annual death rate associated with HIV-1 infection was 5 3 per 1000 and in adults 7 9 per 1000. Highest excess mortality was 16 9 per 1000 in the age group 25-34. Among adults, half of all deaths and among those aged 13-44 over 80% of deaths were attributable to HIV-1 infection. These results show the strong impact that HIV-1 infection is having on mortality in a rural area of Uganda where the overall HIV-1 adult prevalence rate is below 10%-a rate lower than in many other parts of East Africa. © 1994.