MODELING THE IMPACT OF ALTERNATIVE HIV INTERVENTION STRATEGIES IN RURAL UGANDA

Objective: To assess the likely impact on HIV incidence of increased c ondom use, a reduction in casual sexual partners, treatment programmes for other sexually transmitted diseases (STD) and combinations of the se in rural Uganda. Methods: A simulation model for the transmission d ynamics of HIV infection and STD was employed, drawing on data from a rural population cohort in South-West Uganda with an HIV prevalence of 9% among adults in 1990. Results: For the scenario most consistent wi th data from the study population, 39% of all adult HIV infections wer e averted, in the 10 years from 1990, when condoms were used consisten tly and effectively by 50% of men in their contacts with one-off sexua l partners (such as bar girls and commercial sex workers). Reducing by 50% the frequency of men's sexual contacts with one-off partners aver ted 68% of infections. Reducing by 50% the duration of all STD episode s averted 43% of infections. Combining these three interventions avert ed 82% of all adult infections in the 10 years from 1990. Conclusion: A substantial proportion of HIV infections may be averted in general p opulations through interventions targeted only on less regular sexual partnerships.