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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Behavioral, biological, and demographic risk and protective factors for new HIV infections among youth in Rakai, Uganda
Journal of Acquired Immune Deficiency Syndromes, Volume 63, No. 3, Year 2013
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Description
Background: Prevalence of HIV infection is considerable among youth, although data on risk factors for new (incident) infections are limited. We examined incidence of HIV infection and risk and protective factors among youth in rural Uganda, including the role of gender and social transitions. Methods: Participants were sexually experienced youth (15-24 years old) enrolled in the Rakai Community Cohort Study, 1999-2008 (n = 6741). Poisson regression with robust standard errors was used to estimate incident rate ratios (IRR) and 95% confidence intervals (CI) of incident HIV infection. Results: HIV incidence was greater among young women than young men (14.1 vs. 8.3 per 1000 person-years, respectively); this gender disparity was greater among teenagers (14.9 vs. 3.6). Beyond behavioral (multiple partners and concurrency) and biological factors (sexually transmitted infection symptoms), social transitions such as marriage and staying in school influenced HIV risk. In multivariate analyses among women, HIV incidence was associated with living in a trading village (adjusted IRR (aIRR) = 1.48; 95% CI: 1.04 to 2.11), being a student (aIRR = 0.22; 95% CI: 0.07 to 0.72), current marriage (aIRR = 0.55; 95% CI: 0.37 to 0.81), former marriage (aIRR = 1.73; 95% CI: 1.01 to 2.96), having multiple partners, and sexually transmitted infection symptoms. Among men, new infections were associated with former marriage (aIRR = 5.57; 95% CI: 2.51 to 12.36), genital ulceration (aIRR = 3.56; 95% CI: 1.97 to 6.41), and alcohol use (aIRR = 2.08; 95% CI: 1.15 to 3.77). Conclusions: During the third decade of the HIV epidemic in Uganda, HIV incidence remains considerable among youth, with young women particularly at risk. The risk for new infections was strongly shaped by social transitions such as leaving school, entrance into marriage, and marital dissolution; the impact of marriage was different for young men than women. Copyright © 2013 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Santelli, John S.
United States, New York
Mailman School of Public Health
Edelstein, Zoe R.
United States, New York
Mailman School of Public Health
Mathur, Sanyukta
United States, New York
Mailman School of Public Health
Wei, Ying
United States, New York
Mailman School of Public Health
Zhang, Wenfei
United States, New York
Mailman School of Public Health
Orr, Mark G.
United States, New York
Mailman School of Public Health
Higgins, Jenny A.
United States, Madison
University of Wisconsin-madison
Nalugoda, Fred Kakaire
Uganda, Entebbe
Uganda Virus Research Institute
Gray, Ronald H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Wawer, Maria J.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Serwadda, David Musoke
Uganda, Entebbe
Uganda Virus Research Institute
Statistics
Citations: 97
Authors: 11
Affiliations: 4
Identifiers
Doi:
10.1097/QAI.0b013e3182926795
ISSN:
15254135
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Substance Abuse
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda
Participants Gender
Male
Female