International Journal of Epidemiology, Vol 26, 180-189, Copyright © 1997 by International Epidemiological Association
NJ Robinson, DW Mulder, B Auvert and RJ Hayes
BACKGROUND: Unprotected heterosexual contact in the presence of other
sexually transmitted diseases (STD) enhances the probability of HIV
transmission. The objective of this study was to estimate the proportion of
HIV infections attributable to STD in rural Uganda. METHODS: Simulation
modelling scenarios of the transmission dynamics of HIV infection and of
ulcerative and non-ulcerative STD were employed to address this objective,
drawing on data from a specific rural population cohort of 10,000 in
south-west Uganda. RESULTS: In simulations of the initial 10-year period of
the HIV epidemic (1980- 1990), over 90% of HIV infections were attributed
to STD. Even given conservative assumptions about the prevalence of STD and
about their enhancing effects on HIV transmission, STD played a critical
role in the rapid and extensive spread of HIV infection. The role of STD
decreased with progression of the HIV epidemic. CONCLUSIONS: In developing
countries, control of the spread of HIV infection may benefit substantially
from successful STD intervention programmes, and particularly in areas
where HIV infection is not already well established.
ARTICLES
Proportion of HIV infections attributable to other sexually transmitted diseases in a rural Ugandan population: simulation model estimates
Tropical Health Epidemiology Unit, London School of Hygiene and Tropical Medicine, UK.
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