Risk perception and HIV-1 prevalence in 15000 adults in rural south-west Uganda

Objective: Few studies have described levels and determinants of perceived risk of HIV-1 among African adults for whom the sere-status is known. This study describes HIV risk perception obtained from a large rural population in south-west Uganda which also underwent serological testing for HIV. Design: Cross-sectional survey. Methods: Information on risk perception and sexual behaviour was collected by interview. Sera were obtained from all consenting adults (13 years and a bove) in order to assess HIV-1 prevalence. Results: Of 14 818 adults with a definitive sere-status, 9.7% were HIV-1 po sitive and 51% considered themselves to be at risk of infection. Risk perce ption showed similar patterns as age- and sex-specific sere-prevalence and there was correspondence between risk factors for perceived risk and known HIV risk factors. Partner's sexual behaviour was the commonest reason for r isk perception in women whereas men cited their own sexual behaviour. Absti nence from sex was much more commonly mentioned as a protective practice th an condom use in men and women. Conclusion: Half of the adults we have studied already see infection with H IV as a real possibility in their lives and are aware of HIV risk behaviour s. More efforts should be made to implement sustainable control measures ra ther than simply raising awareness. In addition to recommending abstinence, these include mutual faithfulness, condom use and better treatment for STD s. (C) 1999 Lippincott Williams & Wilkins.