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Testing the effects of STD control on AIDS prevention is feasible in this Ugandan setting.

A new collaborative model of research is needed to increase resources, to prioritize the R (ii) to increase the pace, reduce the overlap, and more systematically explore the elements of and delivery systems for vaccines; (iii) to use common standards for the prompt comparative testing of vaccine candidates; (iv) to expand resources for manufacturing vaccine candidates to speed their use in human trials; and (v) to increase the capacity for international clinical trials and to focus this effort toward quickly measuring the effectiveness of vaccine protection as prototype vaccine candidates are identified.

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Risk factor data were collected in 1,328 inpatients and outpatients in 1987 in 15 hospitals throughout Uganda; 42% were positive for HIV antibodies by ELISA. Seropositivity was associated with urban residence, sexually transmitted diseases (STD), number of sex partners, and sex for payment or with a person with an AIDS-like illness. Homosexuality and intravenous drug abuse, recognized risk factors in western countries, were not seen as risk factors. By multivariate analysis, urban residence and sex for payment were not independently associated with infection. Among females, number of sex partners, sex with a person with an AIDS-like illness, and numbers of episodes of STDs were significantly associated with seropositivity. In males, similar associations were seen, although number of reported sex partners was not independently associated with infection. These findings support the view that heterosexual contact is the predominant mode of transmission in Uganda and suggest that the main risk factors relate to high-risk heterosexual behavior.