HIV Incidence Drop in Uganda From 1999-2016

HealthDay News — The incidence of HIV infection declined significantly in Uganda between 1999 and 2016, according to a study published in the New England Journal of Medicine.

M. Kate Grabowski, PhD, from the Johns Hopkins School of Medicine in Baltimore, and colleagues examined the correlation between the incidence of HIV and the scale-up of antiretroviral therapy (ART) and medical male circumcision in Uganda. Data were obtained from 30 communities for 33,937 individuals aged 15 to 49 years.

The researchers found that ART was introduced in 2004, and coverage was 69% by 2016 (72% among women and 61% among men). Among all HIV-positive persons, HIV viral-load suppression increased from 42% in 2009 to 75% by 2016 (P < .001). 

From 1999 to 2016 there was an increase in male circumcision (from 15% to 59%; P < .001). During this time period there was an increase in the percentage of adolescents who reported never having initiated sex (from 30% to 55%; P <.001). The mean incidence of HIV infection decreased by 42% by 2016, relative to the period before 2006, from 1.17 to 0.66 cases per 100 person-years (adjusted incidence rate ratio, 0.58).

“The incidence of HIV infection declined significantly with the scale-up of a combination strategy for HIV prevention, which provides empirical evidence that interventions for HIV prevention can have a population-level effect,” the authors write.

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Grabowski MK, Serwadda DM, Gray RH, Rakai Health Sciences Program, et al. HIV prevention efforts and incidence of HIV in Uganda. N Engl J Med. 2017 Nov 30;377(22):2154-2166.