Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda

Joseph K. Konde-Lule, Maria J Wawer, Nelson K. Sewankambo, David Serwadda, Robert Kelly, Chuanjun Li, Ronald H Gray, David Kigongo

Research output: Contribution to journalArticle

Abstract

Objectives: To describe the epidemiology of HIV-1 infection among adolescents aged 13-19 years, in rural Rakai district, Uganda. Study design: Baseline survey and 2-year follow-up (1990-1992) of adolescents in a population-based, open rural cohort. Methods: Annual enumeration and behavioral/serological survey of all consenting adolescents aged 13-19 years at recruitment, residing in 31 randomly selected community clusters. Results: At baseline, of 909 adolescents present in study clusters, 824 (90.6%) provided interview data and serological samples. No adolescents aged 13-14 years were HIV-infected. Among those aged 15-19 years, 1.8% of men and 19.0% of women were HIV-positive. Among young women aged 15-19 years in marital/consensual union, 21.3% were HIV-positive; this rate did not differ significantly from the 29.1% prevalence in those reporting non-permanent relationships; prevalence was significantly lower in women reporting no current relationship (4.3%). After multivariate adjustment, female sex, age 17-19 years, residence in trading centers/trading villages and a history of sexually transmitted disease symptoms remained significantly associated with HIV infection. Seventy-nine per cent of adolescents provided a follow-up serological sample. No young men aged 13-14 years seroconverted during the study; in young women aged 13-14 years, HIV seroincidence was 0.6 per 100 person-years (PY) of observation. Among young men aged 15-19 years, there were 1.1 ± 0.6 seroconversions per 100 PY of observation prior to age 21 years; among women 15-19 years, the incidence rate was 3.9 ± 1.0 per 100 PY of observation prior to age 21 years. The mortality rate among HIV-positive adolescents aged 15-19 years, at 3.9 per 100 PY of observation, was 13-fold higher than that among the HIV-uninfected. By 1992, knowledge of sexual transmission was almost universal, the proportions reporting multiple partners had decreased and condom use had increased over baseline. Conclusions: Adolescents, and young women in particular, are vulnerable to HIV infection. Despite reported behavioral changes, HIV incidence rates remain substantial, and there is a need for innovative HIV preventive measures.

Original languageEnglish (US)
Pages (from-to)791-799
Number of pages9
JournalAIDS
Volume11
Issue number6
StatePublished - 1997

Fingerprint

Adolescent Behavior
Uganda
Sexual Behavior
HIV-1
HIV
Observation
HIV Infections
Social Adjustment
Sexual Partners
Incidence
Condoms
Sexually Transmitted Diseases
Marriage
Epidemiology
Interviews
Mortality

Keywords

  • Adolescents
  • HIV
  • Incidence
  • Prevalence
  • Sexual behaviors
  • Uganda

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Konde-Lule, J. K., Wawer, M. J., Sewankambo, N. K., Serwadda, D., Kelly, R., Li, C., ... Kigongo, D. (1997). Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda. AIDS, 11(6), 791-799.

Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda. / Konde-Lule, Joseph K.; Wawer, Maria J; Sewankambo, Nelson K.; Serwadda, David; Kelly, Robert; Li, Chuanjun; Gray, Ronald H; Kigongo, David.

In: AIDS, Vol. 11, No. 6, 1997, p. 791-799.

Research output: Contribution to journalArticle

Konde-Lule, JK, Wawer, MJ, Sewankambo, NK, Serwadda, D, Kelly, R, Li, C, Gray, RH & Kigongo, D 1997, 'Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda', AIDS, vol. 11, no. 6, pp. 791-799.
Konde-Lule JK, Wawer MJ, Sewankambo NK, Serwadda D, Kelly R, Li C et al. Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda. AIDS. 1997;11(6):791-799.
Konde-Lule, Joseph K. ; Wawer, Maria J ; Sewankambo, Nelson K. ; Serwadda, David ; Kelly, Robert ; Li, Chuanjun ; Gray, Ronald H ; Kigongo, David. / Adolescents, sexual behavior and HIV-1 in rural Rakai district, Uganda. In: AIDS. 1997 ; Vol. 11, No. 6. pp. 791-799.
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AU - Kelly, Robert

AU - Li, Chuanjun

AU - Gray, Ronald H

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N2 - Objectives: To describe the epidemiology of HIV-1 infection among adolescents aged 13-19 years, in rural Rakai district, Uganda. Study design: Baseline survey and 2-year follow-up (1990-1992) of adolescents in a population-based, open rural cohort. Methods: Annual enumeration and behavioral/serological survey of all consenting adolescents aged 13-19 years at recruitment, residing in 31 randomly selected community clusters. Results: At baseline, of 909 adolescents present in study clusters, 824 (90.6%) provided interview data and serological samples. No adolescents aged 13-14 years were HIV-infected. Among those aged 15-19 years, 1.8% of men and 19.0% of women were HIV-positive. Among young women aged 15-19 years in marital/consensual union, 21.3% were HIV-positive; this rate did not differ significantly from the 29.1% prevalence in those reporting non-permanent relationships; prevalence was significantly lower in women reporting no current relationship (4.3%). After multivariate adjustment, female sex, age 17-19 years, residence in trading centers/trading villages and a history of sexually transmitted disease symptoms remained significantly associated with HIV infection. Seventy-nine per cent of adolescents provided a follow-up serological sample. No young men aged 13-14 years seroconverted during the study; in young women aged 13-14 years, HIV seroincidence was 0.6 per 100 person-years (PY) of observation. Among young men aged 15-19 years, there were 1.1 ± 0.6 seroconversions per 100 PY of observation prior to age 21 years; among women 15-19 years, the incidence rate was 3.9 ± 1.0 per 100 PY of observation prior to age 21 years. The mortality rate among HIV-positive adolescents aged 15-19 years, at 3.9 per 100 PY of observation, was 13-fold higher than that among the HIV-uninfected. By 1992, knowledge of sexual transmission was almost universal, the proportions reporting multiple partners had decreased and condom use had increased over baseline. Conclusions: Adolescents, and young women in particular, are vulnerable to HIV infection. Despite reported behavioral changes, HIV incidence rates remain substantial, and there is a need for innovative HIV preventive measures.

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