HIV incidence and risk factors for acquisition in HIV discordant couples in Masaka, Uganda: an HIV vaccine preparedness study
| Autor: | Ubaldo Bahemuka, Eugene Ruzagira, Anatoli Kamali, Agnes N. Bwanika, Andrew Abaasa, Symon Wandiembe, Matthew Price, Heiner Grosskurth, Pauli N. Amornkul |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
Epidemiology lcsh:Medicine HIV Infections law.invention Pregnancy Risk Factors law Clinical Epidemiology Uganda Young adult HIV vaccine lcsh:Science AIDS Vaccines Vaccines Family Characteristics education.field_of_study Multidisciplinary Obstetrics Incidence Incidence (epidemiology) Vaccination Middle Aged HIV epidemiology Cohort Medicine Infectious diseases Female Research Article Cohort study Adult medicine.medical_specialty Adolescent HIV prevention Population Viral diseases Infectious Disease Epidemiology Young Adult Condom Acquired immunodeficiency syndrome (AIDS) Vaccine Development medicine Humans education business.industry lcsh:R Immunity HIV medicine.disease Immunology Clinical Immunology lcsh:Q business Follow-Up Studies |
| Zdroj: | PLoS ONE, Vol 6, Iss 8, p e24037 (2011) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | OBJECTIVES: To determine the incidence of and risk factors for HIV acquisition in a cohort of HIV-uninfected partners from HIV discordant couples in Masaka, Uganda, and to establish its suitability for HIV vaccine trials. METHODS: HIV-uninfected adults living in HIV discordant couple relationships were enrolled and followed for 2 years. Interviews, medical investigations, HIV counseling and testing, syphilis and urine pregnancy (women) tests were performed at quarterly visits. Sexual risk behaviour data were collected every 6 months. RESULTS: 495 participants were enrolled, of whom 34 seroconverted during 786.6 person-years of observation (PYO). The overall HIV incidence rate [95% confidence interval (CI)] was 4.3 [3.1-6]; and 4.3 [2.8-6.4] and 4.4 [2.5-8] per 100 PYO in men and women respectively. Independent baseline predictors for HIV acquisition were young age [18-24 (aRR = 4.1, 95% CI 1.6-10.8) and 25-34 (aRR = 2.7, 95% CI 1.2-5.8) years]; alcohol use (aRR = 2.6, 95% CI 1.1-6); and reported genital discharge (aRR = 3.4, 95% CI 1.6-7.2) in the past year. Condom use frequency in the year preceding enrolment was predictive of a reduced risk of HIV acquisition [sometimes (aRR = 0.4, 95% CI 0.2-0.8); always (aRR = 0.1, 95% CI 0.02-0.9)]. In the follow-up risk analysis, young age [18-24 (aRR = 6.2, 95% CI 2.2-17.3) and 25-34 (aRR = 2.3, 95% CI 1.1-5.0) years], reported genital discharge (aRR = 2.5, 95% CI 1.1-5.5), serological syphilis (aRR 3.2, 95% CI 1.3-7.7) and the partner being ART naïve (aRR = 4.8, 95% CI 1.4-16.0) were independently associated with HIV acquisition. There were no seroconversions among participants who reported consistent condom use during the study. CONCLUSIONS: The study has identified important risk factors for HIV acquisition among HIV discordant couples. HIV-uninfected partners in discordant couples may be a suitable population for HIV vaccine efficacy trials. However, recent confirmation that ART reduces heterosexual HIV transmission may make it unfeasible to conduct HIV prevention trials in this population. |
| Databáze: | OpenAIRE |
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