Abstract : This study sought to examine risk factors for HIV-1 infection in 3 geographic strata (main road trading centers that service local and international traffic, small trading villages on secondary dirt roads that serve as foci for local communications, and agricultural villages off main and secondary roads) in Rakai District, Uganda. Serological, sociodemographic, knowledge/behaviors, and health surveys were conducted in 21 randomly selected community clusters and complete data was collected for 1292 consenting adults. 15% of the men and 24% of the women were HIV-1 positive. On univariate analysis, several sociodemographic and behavioral factors were significantly associated with risk of HIV infection, including age, place of residence, travel, occupation, marital status, number of sexual partners; sex for money or gifts, history of sexually transmitted diseases (STD), and history of injections. On multivariate analysis, age, residence, and number of sex partners remained significantly associated with HIV infection in both sexes; a history of STD and not having been circumcised were significant in men. There was a significant interaction between place of residence and reported number of sexual partners. For any given level of sexual activity, the risk of HIV infection was markedly increased if the background community prevalence was high. Sexual transmission appears to be the primary behavioral risk factor for infection, but the risks associated with this factor vary substantially between the 3 geographic strata. These data can be used to design targeted interventions. (author's)
Notes : English
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