Marriage and the risk of incident hiv infection in rakai, uganda

Fred Nalugoda, David Guwatudde, John B. Bwaninka, Fredrick E. Makumbi, Tom Lutalo, Joseph Kagaayi, Nelson K. Sewankambo, Godfrey Kigozi, David M. Serwadda, Xiangrong Kong, Maria J Wawer, Fred Wabwire-Mangen, Ronald H Gray

Research output: Contribution to journalArticle

Abstract

Objective: Studies suggest that the prevalence of HIV is higher among long-term marital/consensual relationships than in the unmarried. We assessed the risk of incident HIV infection by marital status in rural Rakai, Uganda. Design: Longitudinal data from the Rakai Community Cohort Study between 1999 and 2011. Methods: We estimated HIV incidence per 100 person years (py) in sexually active individuals aged 15-49 years with a total of 44,179.6 py who were never married (women 2929 py and men 4261 py), currently married or in long-term consensual relationships (currently married women 29,823 py and men 21,299 py) and previously married (women 3563 py and men 1475). Poisson multivariable regression was used to estimate the unadjusted and adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of HIV acquisition. Results: The HIV incidence among currently married persons was 0.93/100 py, which was lower than that for the never-married (1.51/100 py) and previously married (2.85/100 py) persons. The risk of HIV acquisition was significantly lower in the currently married compared with that in the never married among women (Adj IRR = 0.26, 95% CI: 0.16 to 0.42), but not among men (Adj IRR = 0.69, 95% CI: 0.31 to 1.52). HIV incidence was lower among first marriages (0.73/100 py) compared with that among second-or higherorder marriages (1.38/100 py). Multiple sex partners significantly increased the risk of HIV acquisition in both women (Adj IRR = 2.53, 95% CI: 1.6 to 3.97) and men (Adj IRR = 1.77, 95% CI: 1.20 to 2.60). Conclusions: Current marriage especially first-order marriage was associated with a reduced risk of HIV acquisition in women, but not in men, and multiple sex partnerships increased HIV risk for both sexes.

Original languageEnglish (US)
Pages (from-to)91-98
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume65
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Uganda
Marriage
Infection
HIV
Incidence
Confidence Intervals
Sexual Partners
Marital Status
Spouses
HIV Infections
Cohort Studies

Keywords

  • HIV infection
  • Marriage
  • Uganda

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Marriage and the risk of incident hiv infection in rakai, uganda. / Nalugoda, Fred; Guwatudde, David; Bwaninka, John B.; Makumbi, Fredrick E.; Lutalo, Tom; Kagaayi, Joseph; Sewankambo, Nelson K.; Kigozi, Godfrey; Serwadda, David M.; Kong, Xiangrong; Wawer, Maria J; Wabwire-Mangen, Fred; Gray, Ronald H.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 65, No. 1, 2014, p. 91-98.

Research output: Contribution to journalArticle

Nalugoda, F, Guwatudde, D, Bwaninka, JB, Makumbi, FE, Lutalo, T, Kagaayi, J, Sewankambo, NK, Kigozi, G, Serwadda, DM, Kong, X, Wawer, MJ, Wabwire-Mangen, F & Gray, RH 2014, 'Marriage and the risk of incident hiv infection in rakai, uganda', Journal of Acquired Immune Deficiency Syndromes, vol. 65, no. 1, pp. 91-98. https://doi.org/10.1097/QAI.0b013e3182a7f08a
Nalugoda, Fred ; Guwatudde, David ; Bwaninka, John B. ; Makumbi, Fredrick E. ; Lutalo, Tom ; Kagaayi, Joseph ; Sewankambo, Nelson K. ; Kigozi, Godfrey ; Serwadda, David M. ; Kong, Xiangrong ; Wawer, Maria J ; Wabwire-Mangen, Fred ; Gray, Ronald H. / Marriage and the risk of incident hiv infection in rakai, uganda. In: Journal of Acquired Immune Deficiency Syndromes. 2014 ; Vol. 65, No. 1. pp. 91-98.
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abstract = "Objective: Studies suggest that the prevalence of HIV is higher among long-term marital/consensual relationships than in the unmarried. We assessed the risk of incident HIV infection by marital status in rural Rakai, Uganda. Design: Longitudinal data from the Rakai Community Cohort Study between 1999 and 2011. Methods: We estimated HIV incidence per 100 person years (py) in sexually active individuals aged 15-49 years with a total of 44,179.6 py who were never married (women 2929 py and men 4261 py), currently married or in long-term consensual relationships (currently married women 29,823 py and men 21,299 py) and previously married (women 3563 py and men 1475). Poisson multivariable regression was used to estimate the unadjusted and adjusted incidence rate ratios (IRRs) and 95{\%} confidence intervals (CIs) of HIV acquisition. Results: The HIV incidence among currently married persons was 0.93/100 py, which was lower than that for the never-married (1.51/100 py) and previously married (2.85/100 py) persons. The risk of HIV acquisition was significantly lower in the currently married compared with that in the never married among women (Adj IRR = 0.26, 95{\%} CI: 0.16 to 0.42), but not among men (Adj IRR = 0.69, 95{\%} CI: 0.31 to 1.52). HIV incidence was lower among first marriages (0.73/100 py) compared with that among second-or higherorder marriages (1.38/100 py). Multiple sex partners significantly increased the risk of HIV acquisition in both women (Adj IRR = 2.53, 95{\%} CI: 1.6 to 3.97) and men (Adj IRR = 1.77, 95{\%} CI: 1.20 to 2.60). Conclusions: Current marriage especially first-order marriage was associated with a reduced risk of HIV acquisition in women, but not in men, and multiple sex partnerships increased HIV risk for both sexes.",
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AU - Nalugoda, Fred

AU - Guwatudde, David

AU - Bwaninka, John B.

AU - Makumbi, Fredrick E.

AU - Lutalo, Tom

AU - Kagaayi, Joseph

AU - Sewankambo, Nelson K.

AU - Kigozi, Godfrey

AU - Serwadda, David M.

AU - Kong, Xiangrong

AU - Wawer, Maria J

AU - Wabwire-Mangen, Fred

AU - Gray, Ronald H

PY - 2014

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N2 - Objective: Studies suggest that the prevalence of HIV is higher among long-term marital/consensual relationships than in the unmarried. We assessed the risk of incident HIV infection by marital status in rural Rakai, Uganda. Design: Longitudinal data from the Rakai Community Cohort Study between 1999 and 2011. Methods: We estimated HIV incidence per 100 person years (py) in sexually active individuals aged 15-49 years with a total of 44,179.6 py who were never married (women 2929 py and men 4261 py), currently married or in long-term consensual relationships (currently married women 29,823 py and men 21,299 py) and previously married (women 3563 py and men 1475). Poisson multivariable regression was used to estimate the unadjusted and adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of HIV acquisition. Results: The HIV incidence among currently married persons was 0.93/100 py, which was lower than that for the never-married (1.51/100 py) and previously married (2.85/100 py) persons. The risk of HIV acquisition was significantly lower in the currently married compared with that in the never married among women (Adj IRR = 0.26, 95% CI: 0.16 to 0.42), but not among men (Adj IRR = 0.69, 95% CI: 0.31 to 1.52). HIV incidence was lower among first marriages (0.73/100 py) compared with that among second-or higherorder marriages (1.38/100 py). Multiple sex partners significantly increased the risk of HIV acquisition in both women (Adj IRR = 2.53, 95% CI: 1.6 to 3.97) and men (Adj IRR = 1.77, 95% CI: 1.20 to 2.60). Conclusions: Current marriage especially first-order marriage was associated with a reduced risk of HIV acquisition in women, but not in men, and multiple sex partnerships increased HIV risk for both sexes.

AB - Objective: Studies suggest that the prevalence of HIV is higher among long-term marital/consensual relationships than in the unmarried. We assessed the risk of incident HIV infection by marital status in rural Rakai, Uganda. Design: Longitudinal data from the Rakai Community Cohort Study between 1999 and 2011. Methods: We estimated HIV incidence per 100 person years (py) in sexually active individuals aged 15-49 years with a total of 44,179.6 py who were never married (women 2929 py and men 4261 py), currently married or in long-term consensual relationships (currently married women 29,823 py and men 21,299 py) and previously married (women 3563 py and men 1475). Poisson multivariable regression was used to estimate the unadjusted and adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of HIV acquisition. Results: The HIV incidence among currently married persons was 0.93/100 py, which was lower than that for the never-married (1.51/100 py) and previously married (2.85/100 py) persons. The risk of HIV acquisition was significantly lower in the currently married compared with that in the never married among women (Adj IRR = 0.26, 95% CI: 0.16 to 0.42), but not among men (Adj IRR = 0.69, 95% CI: 0.31 to 1.52). HIV incidence was lower among first marriages (0.73/100 py) compared with that among second-or higherorder marriages (1.38/100 py). Multiple sex partners significantly increased the risk of HIV acquisition in both women (Adj IRR = 2.53, 95% CI: 1.6 to 3.97) and men (Adj IRR = 1.77, 95% CI: 1.20 to 2.60). Conclusions: Current marriage especially first-order marriage was associated with a reduced risk of HIV acquisition in women, but not in men, and multiple sex partnerships increased HIV risk for both sexes.

KW - HIV infection

KW - Marriage

KW - Uganda

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