HIV-1 RISK AND VACCINE ACCEPTABILITY IN THE UGANDAN MILITARY

Between July and October 1993, 570 19- to 22-year-old volunteers were screened for HIV-1, with a resulting seroprevalence rate of 18.3% (95% CI: 14.0%, 22.6%). A cohort of 249 HIV-1-noninfected military recruit s in the Ugandan Peoples'0 Defense Forces was followed prospectively f or up to 18 months to document rates of HIV-1 seroprevalence, seroconv ersion, and knowledge and attitudes related to vaccine acceptability. The HIV-1 seroincidence rate was 3.56 per 100 person-years (95% CI: 1. 49, 5.62) over 309 person-years of observation, At the 3- and 12-month visits, subjects were interviewed on issues of acceptance and knowled ge about vaccines, including anti-HIV vaccines in particular. More tha n 90% believe that HIV vaccines will not cause HIV infection, and if o ffered, 88% report that they would take the vaccine if they were not a lready infected. Nonvaccine prevention methods were considered less re liable; monogamy and condom use were considered effective by only 33.5 % and 69.3% of the cohort respectively. After completing the vaccine a cceptability questionnaire at the 12-month visit, subjects were offere d an approved polyvalent meningococcal vaccine as an indicator of gene ral vaccine acceptance. All subjects reported receiving at least one p revious vaccination, and 95% willingly accepted the meningococcal vacc ination. The Ugandan military is a stable population at substantial ri sk for HIV-1 infection and may be a suitable population for vaccine ef ficacy trials.