TY - JOUR
T1 - A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda
AU - Wawer, Maria J.
AU - Gray, Ronald H.
AU - Sewankambo, Nelson K.
AU - Serwadda, David
AU - Paxton, Lynn
AU - Berkley, Seth
AU - McNairn, Denise
AU - Wabwire-Mangen, Fred
AU - Li, Chuanjun
AU - Nalugoda, Fred
AU - Kiwanuka, Noah
AU - Lutalo, Thomas
AU - Brookmeyer, Ronald
AU - Kelly, Robert
AU - Quinn, Thomas C.
PY - 1998/7/9
Y1 - 1998/7/9
N2 - Objective: To describe the design and first-round survey results of a trial of intensive sexually transmitted disease (STD) control to reduce HIV-1 incidence. Study design: Randomized, controlled, community-based trial in Rakai District, Uganda. Methods: In this ongoing study, 56 communities were grouped into 10 clusters designed to encompass social/sexual networks; clusters within blocks were randomly assigned to the intervention or control arm. Every 10 months, all consenting resident adults aged 15-59 years are visited in the home for interview and sample collection (serological sample, urine, and, in the case of women, self-administered vaginal swabs). Sera are tested for HIV-1, syphilis, gonorrhea, chlamydia, trichomonas and bacterial vaginosis. Following interview, all consenting adults are offered directly observed, single oral dose treatment (STD treatment in the intervention arm, anthelminthic and iron-folate in the control arm). Treatment is administered irrespective of symptoms or laboratory testing (mass treatment strategy). Both arms receive identical health education, condom and serological counseling services. Results: In the first home visit round, the study enrolled 5834 intervention and 5784 control arm subjects. Compliance with interview, sample collection and treatment was high in both arms (over 90%). Study arm populations were comparable with respect to sociodemographic and behavioral characteristics, and baseline HIV and STD rates. The latter were high: 16.9% of all subjects were HIV-positive, 10.0% had syphilis, and 23.8% of women had trichomonas and 50.9% had bacterial vaginosis. Conclusions: Testing the effects of STD control on AIDS prevention is feasible in this Ugandan setting.
AB - Objective: To describe the design and first-round survey results of a trial of intensive sexually transmitted disease (STD) control to reduce HIV-1 incidence. Study design: Randomized, controlled, community-based trial in Rakai District, Uganda. Methods: In this ongoing study, 56 communities were grouped into 10 clusters designed to encompass social/sexual networks; clusters within blocks were randomly assigned to the intervention or control arm. Every 10 months, all consenting resident adults aged 15-59 years are visited in the home for interview and sample collection (serological sample, urine, and, in the case of women, self-administered vaginal swabs). Sera are tested for HIV-1, syphilis, gonorrhea, chlamydia, trichomonas and bacterial vaginosis. Following interview, all consenting adults are offered directly observed, single oral dose treatment (STD treatment in the intervention arm, anthelminthic and iron-folate in the control arm). Treatment is administered irrespective of symptoms or laboratory testing (mass treatment strategy). Both arms receive identical health education, condom and serological counseling services. Results: In the first home visit round, the study enrolled 5834 intervention and 5784 control arm subjects. Compliance with interview, sample collection and treatment was high in both arms (over 90%). Study arm populations were comparable with respect to sociodemographic and behavioral characteristics, and baseline HIV and STD rates. The latter were high: 16.9% of all subjects were HIV-positive, 10.0% had syphilis, and 23.8% of women had trichomonas and 50.9% had bacterial vaginosis. Conclusions: Testing the effects of STD control on AIDS prevention is feasible in this Ugandan setting.
KW - AIDS prevention
KW - Randomized controlled trial
KW - STD/HIV prevalence
KW - STF mass treatment
KW - Sexually transmitted disease (STD) control
KW - Uganda
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U2 - 10.1097/00002030-199810000-00014
DO - 10.1097/00002030-199810000-00014
M3 - Article
C2 - 9677171
AN - SCOPUS:7144226601
SN - 0269-9370
VL - 12
SP - 1211
EP - 1225
JO - AIDS
JF - AIDS
IS - 10
ER -