Abstract

PIP: In mid-1991, in a Ugandan town on the trans-African highway, interviews were conducted with and blood specimens taken from 389 persons aged 13 to more than 45 years from 154 households to assess the prevalence of HIV-1 infection and to identify its risk factors. The overall HIV-1 prevalence rate stood at 40.4% (35.6% for men and 43.7% for women). The highest HIV-1 prevalence rates were among men aged 35-44 (56.7%) and women aged 20-24 and aged 25-34 (52.9% and 50.6%, respectively). The urban rate was higher than the semi-rural rate (44.1% vs. 25.6%; p 0.005). 65% of all households had at least one HIV-1 seropositive adult. Single adults had a lower HIV-1 seroprevalence rate than ever married adults (e.g., among men, 10.3% vs. 30.8-62.5%) (relative risk [RR] = 2.8; p 0.005). The Baganda ethnic group had the lowest rate, while the Rwandese group had the highest rate (35.8% vs. 59.2%; RR = 1.4). Education did not affect the prevalence rate. Employed persons were more likely to have HIV-1 infection than the unemployed (44.4% vs. 32.6%; p 0.05). The occupations with the highest HIV-1 infection rates were business person (56.2%) and bar attendant (50%). History of blood transfusion did not appear to be a risk factor for HIV-1 infection (28% vs. 41.3% for no history). 33 HIV-1 seropositive adults had never had sexual intercourse. Men were more likely to have had multiple sex partners than women (e.g., having at least 10 lifetime partners, 61% vs. 11%). Seropositivity rates increased greatly with rising numbers of lifetime sexual partners to a maximum of 3 for females, but it continued to rise for men. It increased for men as the number of contacts in the last month increased (p = 0.05 for trend). 14% of men and 18% of women had a genital ulcer disease in the last 6 months. These findings suggest a need for a three-pronged AIDS prevention strategy: improved sexually transmitted disease control, a reduction in partner change, and an increase in condom use.