HIV and syphilis prevalence and associated risk factors among fishing communities of Lake Victoria, Uganda
- Gershim Asiki1,
- Juliet Mpendo2,
- Andrew Abaasa1,
- Collins Agaba1,
- Annet Nanvubya2,
- Leslie Nielsen2,
- Janet Seeley1,3,
- Pontiano Kaleebu1,2,
- Heiner Grosskurth1,4,
- Anatoli Kamali1
- 1Medical Research Council (MRC)/Uganda Virus Research Institute (UVRI)—Uganda Research Unit on AIDS, Entebbe, Uganda
- 2UVRI/International Aids Vaccine Initiative (IAVI)—HIV Vaccine Program, Entebbe, Uganda
- 3School of International Development, University of East Anglia, Norwich, UK
- 4London School of Hygiene and Tropical Medicine, London, UK
- Correspondence to Gershim Asiki, Medical Research Council Research Unit on AIDS, Uganda Virus Research Institute, PO Box 49 Entebbe, Uganda;
Contributors GA: lead author; contributed to the study coordination, data collection and cleaning; wrote the initial draft of the paper by carrying out the literature review, data analysis and interpretation; received comments from the other authors, editorial board and reviewers. AA: co-author; carried out the statistical analysis, interpreted the results and reviewed the manuscript. JM: co-author; contributed to data collection in the clinic, reviewed the draft of the manuscript and provided useful comments. AN: co-author; contributed to the study coordination in some sites, data collection in the clinic and cleaning; reviewed the draft of the manuscript and provided useful comments. CA: co-author; contributed to the coordination of census data collection, reviewed the draft of the manuscript and provided useful comments. LN: co-author; contributed to the initial study design and application for funding; made administrative arrangements for the study; reviewed and provided comments on the manuscript. JS: co-investigator for the study; mainly participated in the census design and other behavioural aspects of the study, application for funding, supervision of the study activities, interpretation of data and extensive review of the manuscript drafts. PK: principal investigator for the study; mainly participated in the design of the study, obtaining funding for the study, supervision of the study activities, interpretation of data and extensive review of the manuscript drafts. HG: director of the MRC unit in Uganda; participated in the design of the study and mainly in the epidemiological aspects related to STIs, supervision of the study activities, interpretation of data and extensive review of the manuscript drafts. AK: site principal investigator for the epidemiological aspects of the study; mainly participated in the design and obtaining funding, supervision of the study activities, interpretation of data and extensive review of the manuscript drafts.
- Accepted 17 June 2011
- Published Online First 10 August 2011
Objectives Recent publications suggest that fishing populations may be highly affected by the HIV epidemic. However, accurate data are scarce. The authors determined HIV and syphilis prevalence and associated risk factors in a fishing population of Lake Victoria in Uganda.
Methods 10 188 volunteers aged ≥13 years from a census carried out in five fishing communities between February and August 2009 were invited to attend central study clinics established in each community. After informed consent, 2005 randomly selected volunteers responded to socio-demographic and risk assessment questions, provided blood for HIV testing and 1618 volunteers were also tested for syphilis. Risk factors were analysed using logistic regression.
Results HIV and active syphilis (rapid plasma reagin titre ≥1:8) prevalences were 28.8% (95% CI 26.8 to 30.8) and 4.3% (95% CI 3.3 to 5.4), respectively, and high risk sexual behaviour was frequently reported. HIV prevalence was independently associated with female sex, increasing age, occupation (highest in fishermen), relationship to household head, self-reported genital sores and knowledge of an HIV infected partner. Alcohol consumption, syphilis and sexually transmitted infections (STIs) reported by health workers were associated with HIV in women, and genital discharge and inconsistent condom use in men. Syphilis prevalence was independently associated with age and alcohol consumption in women, and recent genital sores and sex under the influence of drugs in men.
Conclusion This fishing population characterised by a very high HIV prevalence, high syphilis prevalence and frequently reported sexual risk behaviours, urgently needs improved STI services and targeted behavioural interventions.
Funding European and Developing Countries Clinical Trials Partnership(EDCTP), The Hague, The Netherlands.
Competing interests None.
Ethics approval This study was conducted with the approval of the Uganda Virus Research Institute.
Provenance and peer review Not commissioned; externally peer reviewed.