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The contribution of HIV incidence and antiretroviral (ART) accessibility to HIV prevalence trends among adults in rural South West Uganda Jessica Nakiyingi-Miiro MRC/UVRI Uganda Research Unit on AIDS Date: 22 July 2014. Study site. Background

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Study site

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  1. The contribution of HIV incidence and antiretroviral (ART) accessibility to HIV prevalence trends among adults in rural South West Uganda Jessica Nakiyingi-Miiro MRC/UVRI Uganda Research Unit on AIDS Date: 22 July 2014

  2. Study site Background • In the 1990s, HIV prevalence and incidence declined in Uganda; attributed primarily to a reduction in risky sexual behaviour. • The latest Uganda sero-behavioural survey indicates that national HIV prevalence increased from 6.4% in 2004/05 to 7.3% in 2011. Objective • To obtain the association of HIV incidence trends and ART uptake with HIV prevalence trends using longitudinal data from rural Uganda Methods • Annual census and socio-demographic data from approx 10,000 adults • Annual health data and HIV serology until 2011, then biennial • Free ART introduced in the area in 2004; 42% on ART by end of 2012.

  3. Results • 27,257 participants: 46% males; 61% resident at joining • Average annual migration: 8.2% in-migrants; 10.3% out-migrants Table 1: HIV prevalence

  4. Fig 5: Distribution of HIV positive cases Discussion Recent increase in HIV prevalence may be due to: • the increasing ART uptake; • declining mortality among HIV-infected adults; and • higher HIV prevalence among in/out-migrants

  5. Acknowledgement • This research is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement. • Study participants from the MRC General Population Cohort • Staff of MRC/UVRI Uganda • Prof. Ziv Shkedy of Hasselt university, Belgium • Conference attendance funded by AIDS 2014

  6. Additional slides Residents and new-borns

  7. Fig 2.2: Distribution of HIV positive cases in resident population

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