Impact of HIV Infection on Households in Uganda Described

In the present study, F. Nalugoda and colleagues assessed the burden of HIV on households and their leaders in Uganda. The researchers, working with the Uganda Virus Research Institute and The Johns Hopkins University, examined "HIV prevalence, symptomatology, and mortality among adult heads and non-heads of households" in a "community study of 11,536 adults age 15-59, residing in 4,962 households in 56 villages" in the Rakai district.

The censuses indicated there were 4,962 heads and 6,574 non-heads of households. "Interviews were then used to determine socio-demographic/behavioral characteristics," the researchers explained. "HIV seroprevalence was diagnosed by two EIAs with Western blot confirmation," and the "adjusted odds ratio (OR) and 95 percent confidence intervals (CI) of HIV infection in household heads and non-heads were estimated by multivariate logistic regression. Age-adjusted mortality was also assessed."

Test results revealed that "HIV prevalence was 16.9 percent in the population, and 21.5 percent of households had at least one HIV-infected person (p<0.0001)." "HIV prevalence was higher among heads than non-heads of households (21.5 percent and 13.3 percent, respectively, OR=1.79; CI 1.62-1.97)."

According to the study, "Most household heads were males (70.5 percent), and HIV prevalence was 17.8 percent among male heads compared with 6.6 percent in male non-heads of households (OR=2.31; CI 1.65-2.52)." "Women heading households were predominantly widowed, separated, or divorced (64.4 percent). HIV prevalence was 30.5 percent among female heads, compared with 15.6 percent in female non-household heads (OR=1.42; CI 1.15-1.63)." Published data indicate, "Age-adjusted mortality was significantly lower among male household heads than non-heads, both for the HIV-positive (r2=0.68) and HIV-negative men (r2=0.63). Among women, HIV-negative female household heads had significantly higher mortality than HIV-uninfected female non-heads (r2=1.72)."

"HIV disproportionately affects heads of households, particularly males," concluded the researchers. "Mortality due to AIDS is likely to increase the proportion of female-headed households, and adversely affect the welfare of domestic units."

The study, "Burden of Infection Among Heads and Non-Head of Rural Households in Rakai, Uganda," was published in AIDS Care (2004;16(1):107-115).

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