The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda

D. Serwadda, Ronald H Gray, Maria J Wawer, R. Y. Stallings, N. K. Sewankambo, J. K. Konde-Lule, B. Lainjo, R. Kelly

Research output: Contribution to journalArticle

Abstract

Objective: To describe the role of men and women as sources of HIV transmission and to estimate HIV incidence among discordant couples resident in diverse rural communities in Uganda. Setting: Rakai, a rural district in Uganda, East Africa. Methods: A population-based cohort study, which has been conducted as annual serological and behavioral surveys since 1989. Community clusters were stratified into trading centers on main roads, intermediate trading villages on secondary roads and agricultural villages off roads. In the 1990 survey round, serological data were available for 79 discordant and 411 concordant HIV-negative couples aged 13-49 years. The present analysis examines sex-specific seropositivity associated with place of residence and the incidence of seroconversion among discordant couples between 1990 and 1991. Results: Seventy-nine discordant couples were followed; the HIV-positive partner was male in 44 couples (57%) and female in 35 couples (43%). There was marked variation in the sex of the seropositive partner by place of residence: women were the HIV-positive partner in 57% of couples from trading centers, 52% from intermediate villages, and 20% from agricultural communities (P <0.008). Condom use was higher in discordant couples in which the man was the uninfected partner (17.1%) rather than the woman (9.5%). HIV-positive women, but not HIV-positive men, reported significantly more sexual partners and more genital ulcers than seronegative individuals of the same sex. Seroincidence rates among men and women in discordant relationship were 8.7 and 9.2 per 100 person-years (PY), respectively, which was much higher than in concordant seronegative couples (men, 0.82; women, 0.87 per 100 PY). Conclusions: In this Ugandan population, men are the predominant source of new infections in rural villages. Risk factors and preventive behaviors vary with the sex of the infected partner, and seroconversion rates are similar in both sexes.

Original languageEnglish (US)
Pages (from-to)745-750
Number of pages6
JournalAIDS
Volume9
Issue number7
StatePublished - 1995

Fingerprint

Uganda
HIV
Eastern Africa
Sexual Partners
Incidence
Condoms
Rural Population
Population
Ulcer
Cohort Studies

Keywords

  • Discordant couples
  • HIV-1
  • Incidence
  • Rural
  • Social dynamics
  • Uganda

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Serwadda, D., Gray, R. H., Wawer, M. J., Stallings, R. Y., Sewankambo, N. K., Konde-Lule, J. K., ... Kelly, R. (1995). The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda. AIDS, 9(7), 745-750.

The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda. / Serwadda, D.; Gray, Ronald H; Wawer, Maria J; Stallings, R. Y.; Sewankambo, N. K.; Konde-Lule, J. K.; Lainjo, B.; Kelly, R.

In: AIDS, Vol. 9, No. 7, 1995, p. 745-750.

Research output: Contribution to journalArticle

Serwadda, D, Gray, RH, Wawer, MJ, Stallings, RY, Sewankambo, NK, Konde-Lule, JK, Lainjo, B & Kelly, R 1995, 'The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda', AIDS, vol. 9, no. 7, pp. 745-750.
Serwadda D, Gray RH, Wawer MJ, Stallings RY, Sewankambo NK, Konde-Lule JK et al. The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda. AIDS. 1995;9(7):745-750.
Serwadda, D. ; Gray, Ronald H ; Wawer, Maria J ; Stallings, R. Y. ; Sewankambo, N. K. ; Konde-Lule, J. K. ; Lainjo, B. ; Kelly, R. / The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda. In: AIDS. 1995 ; Vol. 9, No. 7. pp. 745-750.
@article{775d6a950633455c9f8b131fad47aafa,
title = "The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda",
abstract = "Objective: To describe the role of men and women as sources of HIV transmission and to estimate HIV incidence among discordant couples resident in diverse rural communities in Uganda. Setting: Rakai, a rural district in Uganda, East Africa. Methods: A population-based cohort study, which has been conducted as annual serological and behavioral surveys since 1989. Community clusters were stratified into trading centers on main roads, intermediate trading villages on secondary roads and agricultural villages off roads. In the 1990 survey round, serological data were available for 79 discordant and 411 concordant HIV-negative couples aged 13-49 years. The present analysis examines sex-specific seropositivity associated with place of residence and the incidence of seroconversion among discordant couples between 1990 and 1991. Results: Seventy-nine discordant couples were followed; the HIV-positive partner was male in 44 couples (57{\%}) and female in 35 couples (43{\%}). There was marked variation in the sex of the seropositive partner by place of residence: women were the HIV-positive partner in 57{\%} of couples from trading centers, 52{\%} from intermediate villages, and 20{\%} from agricultural communities (P <0.008). Condom use was higher in discordant couples in which the man was the uninfected partner (17.1{\%}) rather than the woman (9.5{\%}). HIV-positive women, but not HIV-positive men, reported significantly more sexual partners and more genital ulcers than seronegative individuals of the same sex. Seroincidence rates among men and women in discordant relationship were 8.7 and 9.2 per 100 person-years (PY), respectively, which was much higher than in concordant seronegative couples (men, 0.82; women, 0.87 per 100 PY). Conclusions: In this Ugandan population, men are the predominant source of new infections in rural villages. Risk factors and preventive behaviors vary with the sex of the infected partner, and seroconversion rates are similar in both sexes.",
keywords = "Discordant couples, HIV-1, Incidence, Rural, Social dynamics, Uganda",
author = "D. Serwadda and Gray, {Ronald H} and Wawer, {Maria J} and Stallings, {R. Y.} and Sewankambo, {N. K.} and Konde-Lule, {J. K.} and B. Lainjo and R. Kelly",
year = "1995",
language = "English (US)",
volume = "9",
pages = "745--750",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda

AU - Serwadda, D.

AU - Gray, Ronald H

AU - Wawer, Maria J

AU - Stallings, R. Y.

AU - Sewankambo, N. K.

AU - Konde-Lule, J. K.

AU - Lainjo, B.

AU - Kelly, R.

PY - 1995

Y1 - 1995

N2 - Objective: To describe the role of men and women as sources of HIV transmission and to estimate HIV incidence among discordant couples resident in diverse rural communities in Uganda. Setting: Rakai, a rural district in Uganda, East Africa. Methods: A population-based cohort study, which has been conducted as annual serological and behavioral surveys since 1989. Community clusters were stratified into trading centers on main roads, intermediate trading villages on secondary roads and agricultural villages off roads. In the 1990 survey round, serological data were available for 79 discordant and 411 concordant HIV-negative couples aged 13-49 years. The present analysis examines sex-specific seropositivity associated with place of residence and the incidence of seroconversion among discordant couples between 1990 and 1991. Results: Seventy-nine discordant couples were followed; the HIV-positive partner was male in 44 couples (57%) and female in 35 couples (43%). There was marked variation in the sex of the seropositive partner by place of residence: women were the HIV-positive partner in 57% of couples from trading centers, 52% from intermediate villages, and 20% from agricultural communities (P <0.008). Condom use was higher in discordant couples in which the man was the uninfected partner (17.1%) rather than the woman (9.5%). HIV-positive women, but not HIV-positive men, reported significantly more sexual partners and more genital ulcers than seronegative individuals of the same sex. Seroincidence rates among men and women in discordant relationship were 8.7 and 9.2 per 100 person-years (PY), respectively, which was much higher than in concordant seronegative couples (men, 0.82; women, 0.87 per 100 PY). Conclusions: In this Ugandan population, men are the predominant source of new infections in rural villages. Risk factors and preventive behaviors vary with the sex of the infected partner, and seroconversion rates are similar in both sexes.

AB - Objective: To describe the role of men and women as sources of HIV transmission and to estimate HIV incidence among discordant couples resident in diverse rural communities in Uganda. Setting: Rakai, a rural district in Uganda, East Africa. Methods: A population-based cohort study, which has been conducted as annual serological and behavioral surveys since 1989. Community clusters were stratified into trading centers on main roads, intermediate trading villages on secondary roads and agricultural villages off roads. In the 1990 survey round, serological data were available for 79 discordant and 411 concordant HIV-negative couples aged 13-49 years. The present analysis examines sex-specific seropositivity associated with place of residence and the incidence of seroconversion among discordant couples between 1990 and 1991. Results: Seventy-nine discordant couples were followed; the HIV-positive partner was male in 44 couples (57%) and female in 35 couples (43%). There was marked variation in the sex of the seropositive partner by place of residence: women were the HIV-positive partner in 57% of couples from trading centers, 52% from intermediate villages, and 20% from agricultural communities (P <0.008). Condom use was higher in discordant couples in which the man was the uninfected partner (17.1%) rather than the woman (9.5%). HIV-positive women, but not HIV-positive men, reported significantly more sexual partners and more genital ulcers than seronegative individuals of the same sex. Seroincidence rates among men and women in discordant relationship were 8.7 and 9.2 per 100 person-years (PY), respectively, which was much higher than in concordant seronegative couples (men, 0.82; women, 0.87 per 100 PY). Conclusions: In this Ugandan population, men are the predominant source of new infections in rural villages. Risk factors and preventive behaviors vary with the sex of the infected partner, and seroconversion rates are similar in both sexes.

KW - Discordant couples

KW - HIV-1

KW - Incidence

KW - Rural

KW - Social dynamics

KW - Uganda

UR - http://www.scopus.com/inward/record.url?scp=0029069909&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029069909&partnerID=8YFLogxK

M3 - Article

VL - 9

SP - 745

EP - 750

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 7

ER -