Exploring the association between sexual behavior, socio-demographic and biological factors with HIV infection using data from the 2011 Uganda Aids Indicator Survey (UAIS)

Charles Luswata, The University of Texas School of Public Health

Abstract

New annual HIV infections have been increasing steadily in Uganda despite a decreasing HIV prevalence. This thesis aimed to identify sexual behavior, socio-demographic, biological and other factors associated with HIV infection. Data extracted from the 2011 UAIS, a nationally representative two-staged stratified sample, for sexually active respondents aged 15-59 who provided a blood sample for HIV and syphilis testing were used for modeling (n=18,395). The first model, a design-based logistic regression, was used to examine the association between gender and self-perceived risk of getting HIV interaction effect with HIV infection. The second model, a classification tree, was used to identify important complex higher level interaction effects. Overall, the prevalence of HIV in this study population was 8.15%. Results from the unadjusted analyses show males with a low compared to those with a high self-perceived risk of getting HIV were more likely to engage in high-risk sexual behaviors. After adjusting for other factors, self-perceived risk of getting HIV was significantly associated with HIV infection for uncircumcised male respondents only (p-value = 0.0018). The odds of HIV infection among uncircumcised males with a high self-perceived risk of getting HIV were 65% higher compared to uncircumcised male respondents with a low self-perceived risk of getting HIV (adjusted (adj.) OR = 1.65, 95% CI: 1.21 – 2.26). Also, circumcised males with a high self-perceived risk of contracting HIV had 49% lower odds of HIV infection when compared with uncircumcised males with a high self-perceived risk of contracting HIV (adj. OR = 0.51, 95% CI: 0.28 –0.92). Other factors that were significantly associated with HIV infection included: being married (adj. OR = 1.55, 95% CI: 1.08 – 2.24) or divorced/separated (adj. OR =2.10, 95% CI: 1.35 – 3.26) or widowed (adj. OR =3.74, 95% CI: 2.24 – 6.23) compared to never married, alcohol consumption during sex (adj. OR =1.28, 95% CI: 1.03 – 1.58), engaging in commercial or exchange sex (adj. OR =2.07, 95% CI: 1.36 – 3.17), having an STI (adj. OR =1.60, 95% CI: 1.33 – 1.93), having 2-3 (adj. OR =1.56, 95% CI: 1.17 – 2.08) or 4 or more (adj. OR =1.98, 95% CI: 1.47 –2.68) total lifetime number of sex partners compared to having one, and having 1-2 (adj. OR =1.42, 95% CI: 1.15 – 1.77) or 3-4 (adj. OR =1.32, 95% CI: 1.01 – 1.73) biological children away from home compared to not having a child away from home. The classification tree identified four potential interaction patterns. However, only having an STI × total lifetime number of sex partners was found to be statistically significant after evaluation in the design-based logistic regression model. Overall, the findings of this study provide an insight into Uganda’s HIV epidemic. A number of factors, and interactions amongst them, were found to be associated with HIV infection in 2011. Outstandingly, this data provided evidence that self-perceived risk of getting HIV is significantly associated with HIV infection for uncircumcised males only. Confirmation of these findings in prospective studies may be needed. ^

Subject Area

African studies|Public health|Epidemiology

Recommended Citation

Luswata, Charles, "Exploring the association between sexual behavior, socio-demographic and biological factors with HIV infection using data from the 2011 Uganda Aids Indicator Survey (UAIS)" (2015). Texas Medical Center Dissertations (via ProQuest). AAI10036272.
http://digitalcommons.library.tmc.edu/dissertations/AAI10036272

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