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Modelling the impact of alternative HIV intervention strategies in rural Uganda.

Robinson, N. Jamie; Mulder, Daan W.; Auvert, Bertran; Hayes, Richard J.

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Objective: To assess the likely impact on HIV incidence of increased condom use, a reduction in casual sexual partners, treatment programmes for other sexually transmitted diseases (STD), and combinations of these in rural Uganda.

Methods: A simulation model for the transmission dynamics of HIV infection, and STD was employed, drawing on data from a rural population cohort in South-West Uganda with an HIV prevalence of 9% among adults in 1990.

Results: For the scenario most consistent with data from the study population, 39% of all adult HIV infections were averted, in the 10 years from 1990, when condoms were used consistently, and effectively by 50% of men in their contacts with one-off sexual partners (such as bar girls, and commercial sex workers). Reducing by 50% the frequency of men's sexual contacts with one-off partners averted 68% of infections. Reducing by 50% the duration of all STD episodes averted 43% of infections. Combining these three interventions averted 82% of all adult infections in the 10 years from 1990.

Conclusion: A substantial proportion of HIV infections may be averted in general populations through interventions targeted only on less regular sexual partnerships.

(C) Lippincott-Raven Publishers.


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