Document Detail


Behavioral, biological, and demographic risk and protective factors for new HIV infections among youth in Rakai, Uganda.
MedLine Citation:
PMID:  23535293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
John S Santelli; Zoe R Edelstein; Sanyukta Mathur; Ying Wei; Wenfei Zhang; Mark G Orr; Jenny A Higgins; Fred Nalugoda; Ron H Gray; Maria J Wawer; David M Serwadda
Related Documents :
24953143 - Habitual nutrient intake in hiv-infected youth and associations with hiv-related factors.
7756483 - Value of liver biopsy for the rapid diagnosis of infection in human immunodeficiency vi...
20840743 - Eligibility for and outcome of treatment of latent tuberculosis infection in a cohort o...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  63     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-13     Completed Date:  2013-08-29     Revised Date:  2014-10-28    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-400     Citation Subset:  IM; X    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Alcohol Drinking / epidemiology*
Cohort Studies
Female
HIV Infections / epidemiology*,  transmission
Humans
Incidence
Male
Marriage
Prevalence
Risk
Risk Factors
Rural Health
Sexual Behavior*
Sexual Partners
Sexually Transmitted Diseases / epidemiology
Uganda / epidemiology
Young Adult
Grant Support
ID/Acronym/Agency:
5R01HD061092/HD/NICHD NIH HHS; P30 MH043520/MH/NIMH NIH HHS; R01 HD061092/HD/NICHD NIH HHS; T32 MH019139/MH/NIMH NIH HHS; T32-MH19139/MH/NIMH NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Influence of low-dose ritonavir with and without darunavir on the pharmacokinetics and pharmacodynam...
Next Document:  Reduction in Perinatal HIV infections in KwaZulu-Natal, South Africa in the era of more effective PM...