How sexual contacts with outsiders contribute to HIV infections within communities

While a number of strategies can prevent and control HIV transmission and spread, their effective use depends on understanding the sexual networks within and between communities. A paper published in this week's PLOS Medicine reports a detailed analysis with surprising results from the Rakai district in Uganda, one of the most studied areas of the HIV/AIDS epidemic in Africa.

Mary K. Grabowski, from Johns Hopkins Bloomberg School of Public Health, led an international group of scientists in an effort to test the hypothesis that most people who contract HIV outside their household are infected through sex with someone from their local community. However, studying 46 communities within the Rakai district in Uganda, the researchers found that introductions of HIV from outside the community are frequent and seem to contribute substantially to sustaining the HIV epidemic within the community. While the largest fraction of new infections take place within a household, the majority of new infections outside of the household appear to be contracted by sexual contact with partners from outside the community.

Some of the data rely on the accuracy of self-reported sexual partnerships, but the findings were consistent between three different approaches the scientists used to examine the question. And while it is not known whether the situation in communities outside of Rakai is similar, these results suggest that HIV infections by sexual partners from outside the community are common, and that HIV prevention campaigns need to look beyond communities.

More information: Grabowski MK, Lessler J, Redd AD, Kagaayi J, Laeyendecker O, et al. (2014) The Role of Viral Introductions in Sustaining Community-Based HIV Epidemics in Rural Uganda: Evidence from Spatial Clustering, Phylogenetics, and Egocentric Transmission Models. PLoS Med 11(3): e1001610. DOI: 10.1371/journal.pmed.1001610

add to favorites email to friend print save as pdf

Related Stories

Overcoming barriers to partner notification of HIV

Feb 05, 2014

(Medical Xpress)—Among the most difficult barriers to preventing the spread of HIV are those that hamper the notification of sexual and needle-sharing partners that they have been exposed to the infection. ...

Uganda plans drug boost for AIDS fight

Jan 30, 2014

Uganda's government is planning to double expenditure on anti-retroviral drugs in an effort to reverse a worsening trend in HIV infections, a senior health official said Thursday.

Recommended for you

Condoms 'too small' for Uganda men

Sep 19, 2014

Ugandan MPs have been inundated with complaints that many condoms on sale in the east African nation are too small, warning the problem is a blow to the fight against AIDS.

Withdrawal from the evolutionary race

Sep 18, 2014

In some HIV sufferers, the immune system does not fight off the immune deficiency virus. Instead, the body tolerates the pathogen. A research team headed by ETH Zurich has now determined how strongly patients ...

The genetics of coping with HIV

Sep 16, 2014

We respond to infections in two fundamental ways. One, which has been the subject of intensive research over the years, is "resistance," where the body attacks the invading pathogen and reduces its numbers. Another, which ...

User comments