HIV-1 prevalence and factors associated with infection in the conflict-affected region of North Uganda

Massimo Fabiani¹ , Barbara Nattabi² , Chiara Pierotti³ , Filippo Ciantia³ , Alex A Opio⁴ , Joshua Musinguzi⁴ , Emintone O Ayella² and Silvia Declich¹

¹National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy

²St. Mary's Hospital Lacor, Gulu, Uganda

³AVSI, Kampala, Uganda

⁴National Diseases Control Department, Ministry of Health, Kampala, Uganda

author email corresponding author email

Conflict and Health 2007, 1:3doi:10.1186/1752-1505-1-3


Published:	1 March 2007

Abstract

Background

Since 1986, northern Uganda has been severely affected by civil strife with most of its population currently living internally displaced in protected camps. This study aims at estimating the HIV-1 prevalence among this population and the factors associated with infection.

Methods

In June-December 2005, a total of 3051 antenatal clinics attendees in Gulu, Kitgum and Pader districts were anonymously tested for HIV-1 infection as part of routine sentinel surveillance. Factors associated with the infection were evaluated using logistic regression models.

Results

The age-standardised HIV-1 prevalence was 10.3%, 9.1% and 4.3% in the Gulu, Kitgum and Pader district, respectively. The overall prevalence in the area comprised of these districts was 8.2% when data was weighted according to the districts' population size. Data from all sites combined show that, besides older women [20–24 years: adjusted odds ratio (AOR) = 1.96, 95% confidence interval (CI): 1.29–2.97; 25–29 years: AOR = 2.01, 95% CI: 1.30–3.11; ≥ 30 years: AOR = 1.91, 95% CI: 1.23–2.97], unmarried women (AOR = 1.47, 95% CI: 1.06–2.04), and those with a partner with a non-traditional occupation (AOR = 1.62, 95% CI: 1.18–2.21), women living outside of protected camps for internally displaced persons have a higher risk of being HIV-1 infected than internally displaced women (AOR = 1.55, 95% CI: 1.15–2.08).

Conclusion

Although published data from Gulu district show a declining HIV-1 prevalence trend that is consistent with that observed at the national level since 1993, the prevalence in North Uganda is still high. Internally displaced women have a lower risk of being infected probably because of their reduced mobility and accessibility, and increased access to health prevention services.