Risk Factors Associated with HIV Infection in Uganda

Berkley, Seth; Widy-Wirski, R; Okware, Samuel; Downing, Robert; Linnan, Michael; White, Karen E.; Sempala, S. D. K.

doi:10.1093/infdis/160.1.22

Cited by 70 publications

(32 citation statements)

References 18 publications

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“…Those characteristics which were categorised as pertaining to individual behaviour were the most important in the association, both in the bi-variate and in the multi-variate analyses. Previous studies addressing behavioural characteristics as risk factors have revealed similar patlerns of associations (Hrdy, 1987;Berkley et al, 1989;Cameron et al, 1989;Wasser et al, 1989;Mhalu, 1990;Nsubuga et al, 1990;Martin et al, 1992;Chetwynd et al, 1993). The findings also show that urban residence, perceived inadequacy of knowledge and disrupted or multiple marriage were associated with HIV-I infection.…”

Section: Discussionsupporting

confidence: 67%

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Killewo

Sandström

Dahlgren

et al. 1997

Social Science & Medicine

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Section: Discussionsupporting

confidence: 67%

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Killewo

Sandström

Dahlgren

et al. 1997

Social Science & Medicine

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“…The overall syphilis seroreactivity was 39.1% (160 out of 409 women) and was linked significantly to HIV infection (p < 0.0005) [9]. This emphasizes the fact that the presence of genital ulcers or similar lesions increases the susceptibility of HIV infection as reported in many previous studies [10,11]. The pathology which takes place is the attraction and active infiltration of lymphocytes and macrophages in these lesions and ulcers which facilitate and even force the entrance of the HIV into the blood circulation [12].…”

Section: Discussionsupporting

confidence: 58%

HIV-1 Seroprevalence among Pregnant Women in Rural Uganda: A Longitudinal Study over Fifteen Years

Reuschel

Tibananuka²,

Seelbach-Goebel

2013

Gynecol Obstet Invest

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Introduction: In order to determine the development of the prevalence of HIV infection in rural Western Uganda, data of epidemiological studies conducted in 2001 and 2007 were compared to study data from 1993. Methods: In 2001 (n = 466) and in 2007 (n = 486), one group each of clinically healthy pregnant women of a local prenatal care department were enrolled in the study and anonymously screened for HIV-1. For both groups, informed consent was obtained prior to enrolment. Testing for HIV was done by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot. In addition, age and antibodies against syphilis were determined as risk factors of HIV infection. Results: The seroprevalence of HIV-1 infection did not decrease significantly over this time period, dropping from 28.3 to 25.1% between 2001 and 2007, but the prevalence of syphilis antibodies decreased from 27.9 to 11.1%. The data of 2001 and 2007 were compared to a third cohort from 1993, in which 21.5% of pregnant women were HIV-1-positive and 31.1% were Treponema pallidum hemagglutination assay (TPHA)-positive. Conclusion: The current prevalence of HIV-1 infection in Uganda is still high and there is a need for further promotion of HIV prevention and control services.

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“…As in the USA and Europe, AIDS is very uneven in distribution. Originally, it was reported from Uganda (Serwadda, Sewankambo & Carswell, 1985) as a localised, wasting 'Slim' disease, but now it has become an acute infection strongly linked with tuberculosis (Konotey-Uhulu, 1989;Berkley, Widi-Wirski & Odware, 1989;de Cock et al, 1992). Along with other STDs, AIDS is increasingly prevalent in certain cities on the international travel routes of persons who sample the local risks, and convey their own infections and risk-behaviour to local populations.…”

Section: Weakness In the Hiv Hypothesismentioning

confidence: 99%

The epidemiology and transmission of AIDS: A hypothesis linking behavioural and biological determinants to time, person and place

Stewart

1995

Genetica

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Epidemiologically, the Acquired Immune Deficiency Syndrome, AIDS, is transmitted and distributed in the USA and Europe almost entirely in well-defined subsets of populations engaging in, or subjected to, the effects of behaviours which carry high risks of genital and systemic infections. The persons predominantly affected are those engaging in promiscuous homosexual and bisexual activity, regular use of addictive drugs, and their sexual and recreational partners. In such persons and in subsets of populations with corresponding life-styles, the risk of AIDS increases by orders of magnitude. Because of continuity of risk behaviour and of associated indicator infections, the incidence of AIDS over 3-5 year periods is predictable to within 10% of actual totals of registered cases in the USA and UK. Secondary transmission of AIDS beyond these groups is minimal or, in many locations, absent. There is no indication of appreciable spread by heterosexual transmission to the general population. The Human Immunodeficiency Virus, HIV, is transmissible to some extent in general populations, and more so among promiscuous persons. It may cause viraemia, lymphadenopathy and latent infection (HIV disease) in anyone. In persons engaging in risk behaviours which themselves alter or suppress immune responses, it can interact with MHC, antibodies to other organisms and to semen, and other allogenic antigens to initiate a programmed death of CD4 lymphocytes and other defensive cells, as in graft-host rejections. This occurs also in haemophiliacs receiving transfusions of blood products, and is more pronounced in persons with reactive HLA haplotypes. The susceptibility of particular subsets of populations to AIDS is thereby largely explained. But these changes occur in the absence of HIV, and so do Kaposi's sarcoma, lymphadenopathies and opportunistic infections which are regarded as main indicators of AIDS. The hypothesis that HIV-1 can do all this by itself and thereby cause AIDS is falsifiable on biological as well as epidemiological grounds. An alternative hypothesis is proposed, linking the incidence of AIDS to the evolution of contemporary risk behaviour in particular communities and locations in the USA, UK and probably in most of Europe. It does not pretend to explain the reported incidence of AIDS in Africa and other developing regions where data are insufficient to provide validation of the pattern of disease and contributory variables. The immediate, practical implication of this alternative hypothesis is that existing programmes for the control of AIDS are wrongly orientated, extremely wasteful of effort and expenditure, and in some respects harmful.

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Risk Factors Associated with HIV Infection in Uganda

Cited by 70 publications

References 18 publications

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

HIV-1 Seroprevalence among Pregnant Women in Rural Uganda: A Longitudinal Study over Fifteen Years

The epidemiology and transmission of AIDS: A hypothesis linking behavioural and biological determinants to time, person and place

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