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HIV and syphilis prevalence and associated risk factors among fishing communities of Lake Victoria, Uganda
  1. Gershim Asiki1,
  2. Juliet Mpendo2,
  3. Andrew Abaasa1,
  4. Collins Agaba1,
  5. Annet Nanvubya2,
  6. Leslie Nielsen2,
  7. Janet Seeley1,3,
  8. Pontiano Kaleebu1,2,
  9. Heiner Grosskurth1,4,
  10. Anatoli Kamali1
  1. 1Medical Research Council (MRC)/Uganda Virus Research Institute (UVRI)—Uganda Research Unit on AIDS, Entebbe, Uganda
  2. 2UVRI/International Aids Vaccine Initiative (IAVI)—HIV Vaccine Program, Entebbe, Uganda
  3. 3School of International Development, University of East Anglia, Norwich, UK
  4. 4London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Gershim Asiki, Medical Research Council Research Unit on AIDS, Uganda Virus Research Institute, PO Box 49 Entebbe, Uganda; gershim.asiki{at}mrcuganda.org

Abstract

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.

  • HIV
  • syphilis
  • risk factors
  • fishing communities
  • Uganda
  • Africa
  • prevalence

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Footnotes

  • 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.

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