14th International AIDS Conference Barcelona, Spain - July 7-12, 2002

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrC1269)

Kirungi WL, Musinguzi JB, Opio A, Madraa E
STD/AIDS Control Programme, Ministry of Health, Kampala, Uganda

BACKGROUND: Epidemiological surveillanceof in Uganda has shown consistent decline in HIV prevalence among antenatal and STD clients at sentinel sites. This is corroborated by parallel changes in sexual behaviour.

METHODS: Analysis of annual HIV prevalence data of 250-300 clients from each of 20 sentinel sites (1989-2000) and data on sexual behaviour of about 1500 adults resident in the catchment areas of the sites based on repeated cross-sectional behavioural surveys. Chi square test was used to compare differences and Chi square test for trend was used to test for linear trend in sero prevalence and sexual behaviour.

RESULTS: In 2000, urban-rural disparities in antenatal HIV prevalence were still evident, Median 8.3%, range 11.8%-4.2% in major urban areas, relative to 2.7%, range 10.5%-1.9%, in peri-urban/rural sites. HIV prevalence fell from a highest recorded of any urban site (30.2%, 1992) to a lowest of 4.2% in 2000, while remaining somewhat stable, median under 5% in peri-urban/rural areas. HIV prevalence among STD patients at a clinic in Kampala fell from 44.6 % in 1990 to 20.5%. In 3 areas where HIV prevalence data is available, along side behavioural data from the catchment area, HIV prevalence fell from 30.2%, 29.4% and 19.8% in 1992 to 11.8%, 10.0% and 8.3% respectively. Stratified by age-group, there is a linear trend in sero-prevalence among 15-19 and 20-24 yr age-groups. The proportion of youths at any age, 15-24 yrs who had had their sexual debut, fell by 2-5% between 1995-2000. Reported casual sexual relationships was mixed (14.1% vs 13.7%, 7.8% vs 7.0% and 6.6%Vs 8.7%); however, condom use at last sex with casual partner increased (57.6% vs 76.0%, 34.3% vs 66.7% and 31.9% vs 48%). Reported ever use of condoms increased (42% vs 50.7%, 22.0% vs 28.9%, 13.6% vs 14.5%).

CONCLUSION: These trends in sexual behaviour appear to further support the trends in HIV prevalence, in this HIV epidemic as previously described.

020707
WeOrC1269

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