AEGiS-11IAC: Socio-economic status and sexual networks in a high HIV prevalence population in rural Uganda.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Socio-economic status and sexual networks in a high HIV prevalence population in rural Uganda.

Int Conf AIDS 1996 Jul 7-12; 11:483 (abstract no. Pub.D.1292)
Ssengonzi R, Morris M, Sewankambo N, Serwadda D, Wawer W, Konde-Lule J; Uganda Virus Research Institute (U.V.R.I.), Entebbe, Uganda. Fax: 256-42-20279/20483.

OBJECTIVE: To examine the effect of socio-economic status on sexual networks and behaviors of Rakai residents and the implications for HIV transmission dynamics.

METHODS: A cross-sectional survey nested within a larger longitudinal cohort study of HIV, sexual behavior and fertility was conducted in Rakai District, Uganda in 1992/93. A random sample of 1,627 (15-49 yrs) respondents was interviewed and 1,428 were sexually active. We collected detailed information on sexual behavior with their 3 most recent sexual partners. Socio-economic status was defined by possessions, acreage, housing quality and education. Descriptive statistics were used to compare sexual networks in terms of number and overlap of partnerships by gender, education and economic status.

RESULTS: Adult HIV prevalence in the cohort was 20%. Higher economic status and certain occupations were consistently associated with more partners (lifetime or within last year) and higher levels of concurrent partnerships for both sexes. These occupations included trading, vending and blue collar work for men, and hotel/ bar/ restaurant work and vending for women. For both men and women, having lower economic status than one's partner was associated with high prevalence of HIV risk factors: lower condom use (8% vs 12% for men 7% vs 12% for women) and higher probability of outside partners (88% vs 36% for men and 75% vs 64% for women). While most women report that their partners are better off economically and educationally, adolescent women (15-19), report that their partners typically have less education. Their partners are about 5-10 years older, economically better off, most commonly employed as traders, and 15% of the relationships are one night stands.

CONCLUSIONS: Younger women appear to be more at risk by virtue of relative economic disadvantage. Intervention programs should focus on improving women's relative economic status and thus help in reducing their vulnerability.

Keywords: AEGIS, HIV, Prevalence, Sexual Partners, Social Class, HIV Infections, HIV-1, Population, Cross-Sectional Studies, HIV Seroprevalence, HIV Seropositivity, Cohort Studies, Rural Population, Uganda, Longitudinal Studies, Human, Female, Male, Adolescence, Adult, epidemiology, ICA11

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