Article

Trends in antenatal HIV prevalence in urban Uganda associated with uptake of preventive sexual behaviour

University of North Carolina at Chapel Hill, North Carolina, United States
Sexually Transmitted Infections (Impact Factor: 3.4). 05/2006; 82 Suppl 1(suppl 1):i36-41. DOI: 10.1136/sti.2005.017111
Source: PubMed

ABSTRACT

Epidemiological surveillance in Uganda has consistently shown declining HIV prevalence particularly among young antenatal women since the early 1990s, correlated with increased uptake of protective sexual behaviour.
To describe trends in sexual behaviour nationwide and antenatal HIV prevalence from urban sentinel sites in Uganda (1989-2002).
Review of antenatal HIV seroprevalence data from the sentinel surveillance system (1989-2002) and data on sexual behavioural indicators from the AIDS module of the National Demographic and Health Surveys (1989, 1995 and 2000/01). Trends in biological and behavioural indicators assessed.
Antenatal HIV seroprevalence in seven urban clinics peaked around 1992 (15-30%) followed by a steady decline by 2002 (5-12%), most markedly among women aged 15-19 and 20-24 years. This coincided with increased primary and secondary abstinence among young people nationwide. Median age at sexual debut increased from 16.5 in 1989 to 17.3 in 2000 for women and from 17.6 in 1995 to 18.3 in 2000 for men. Premarital sex among women and multiple partnerships decreased between 1995 and 2000. There were no significant changes in reporting of extramarital sex among men. Ever use of condoms increased from 1% among women in 1989 and 16% among men in 1995 to 16% and 40% in 2000, respectively. Between 1995 and 2000, condom use at last sex with a non-regular partner increased from 35% to 59% and 20% to 39% among men and women, respectively.
The ecological correlation between the trends in HIV prevalence and incidence and the increase in protective sexual behaviour during the 1990s makes a compelling case for continuing prevention efforts in Uganda.

Full-text preview

Available from: bmj.com
  • Source
    • "This effort is associated with decreasing the burden of HIV in sub-Saharan Africa where many of PEPFAR's priority countries are located. In Uganda and Zimbabwe, there was an increase in abstinence and a decrease in HIV prevalence [2] [3]. Self-reported surveys to measure the sexual behaviors of the beneficiaries of abstinence promotion programs are commonly used to assess the effectiveness of these programs. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: It is in order to examine associations between social desirability (SD) and self-reports of abstinence among youths in rural Ethiopia. Methods: Youths of ages 15 -24 (114 participants) were administered questionnaire to assess HIV knowledge and primary abstinence and a modified Marlowe-Crowne Social Desirability Scale to assess SD bias. The relationships between SD groups (dichotomized into high and low) and abstinence by various characteristics were assessed by using Fisher's exact p-values. Results: The odds of individuals reporting abstinence were 13.2 times greater in the high SD group compared to the low SD group (p-value 0.002) when adjusted for education, gender, age group, and HIV knowledge. The differences in abstinence between the high and low SD score groups were also exam-ined for selected variables. Conclusions: Individuals who exhibited more SD bias were more likely to report primary abstinence. SD bias should be considered when conducting self-reported surveys to measure the effectiveness of HIV prevention programs.
    Full-text · Article · Dec 2013 · World Journal of AIDS
  • Source
    • "This effort is associated with decreasing the burden of HIV in sub-Saharan Africa where many of PEPFAR's priority countries are located. In Uganda and Zimbabwe, there was an increase in abstinence and a decrease in HIV prevalence [2] [3]. Self-reported surveys to measure the sexual behaviors of the beneficiaries of abstinence promotion programs are commonly used to assess the effectiveness of these programs. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: It is in order to examine associations between social desirability (SD) and self-reports of abstinence among youths in rural Ethiopia. Methods: Youths of ages 15 -24 (114 participants) were administered questionnaire to assess HIV knowledge and primary abstinence and a modified Marlowe-Crowne Social Desirability Scale to assess SD bias. The relationships between SD groups (dichotomized into high and low) and abstinence by various characteristics were assessed by using Fisher's exact p-values. Results: The odds of individuals reporting abstinence were 13.2 times greater in the high SD group compared to the low SD group (p-value 0.002) when adjusted for education, gender, age group, and HIV knowledge. The differences in abstinence between the high and low SD score groups were also exam-ined for selected variables. Conclusions: Individuals who exhibited more SD bias were more likely to report primary abstinence. SD bias should be considered when conducting self-reported surveys to measure the effectiveness of HIV prevention programs.
    Full-text · Dataset · Oct 2013
  • Source
    • "Although Uganda's HIV prevalence rates plateaued for several years, raising trends in both prevalence and incidence have recently been reported (Kron, 2012). The initial success in Uganda's HIV prevention was attributed to sexual behavioural change (Green et al., 2006) and other strategies that targeted the at-risk-group (HIV negatives) (Kirungi et al., 2006). Recent studies however, have demonstrated the significant role of 'positive prevention' targeting and supporting HIV-infected individuals to modify their behaviour to reduce the risk of future transmission. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the continued enormous financial investment, through both local and donor funding into human immunodeficiency virus (HIV) prevention and care services in Uganda, the prevalence and incidence rates are raising. Knowledge of HIV determines both uptake of HIV prevention services and behavioural change. We assessed knowledge of HIV service sites and testing benefits among Ugandans at community level. Adult participants (n = 5320) were randomly selected for the study. Participants were asked to mention the: (1) nearest facility providing HIV services and estimate its distance from their household and (2) benefits of HIV testing that they knew. Twelve percent had no knowledge of any HIV service site accessible to them, while only 4.4% knew at least 50% of eight benefits of HIV testing, 35% of those without any idea of the benefits of HIV testing did not know HIV service sources. Knowledge of HIV service sources was dependent on age, level of education and marital status with teenagers being least knowledgeable. Many Ugandans neither know the benefits of HIV testing nor the HIV service facilities available for them with teenagers (15 to 19 years old) being least informed on where to seek HIV service. Specific methods of relaying HIV prevention messages to the teenagers are required in Uganda.
    Full-text · Article · Jul 2013
Show more