HIV-1 INFECTION IN A UGANDAN TOWN ON THE TRANS-AFRICAN HIGHWAY - PREVALENCE AND RISK-FACTORS

All adult residents (aged 13 years or more) of 154 randomly selected h ouseholds in 3 urban and one semi-rural ward of a town in South West U ganda on the trans-African highway were invited to participate in a so cio-demographic, behavioural and medical survey. An unambiguous HIV-1 serostatus was obtained for 389 (80%) adults. The overall sere-prevale nce rate was 40.4%; all age groups except males aged 13-19 years had i nfection rates in excess of 20%. Rates above 50% were found in females aged 20-34 years and males aged 35-44 years. For females seropositivi ty rates increased steeply with increasing numbers of lifetime sexual partners up to a maximum of 3; in contrast, for males rates continued to increase with increasing numbers of partners. The risk of infection amongst those with only one reported partner was 17%. A high proporti on of males (14%) and females (18%) reported a history of genital ulce r disease within the previous 6 months; on examination genital lesions were observed in 12% of all participants. Interventions with a single focus are unlikely to have much impact in such a situation and a stra tegy is suggested which includes 3 components, namely improved STD con trol, a reduction in partner change and an increase in condom utilizat ion.