Uganda: Quantifying HIV-1 Transmission Due to Contaminated Injections
March 20, 2008
In order for control efforts to be prioritized, "assessments of the importance of different routes of HIV-1 (HIV) transmission are vital," the authors noted. However, the lack of consistent data and the great uncertainty regarding the risk of HIV transmission from HIV-contaminated injections have made quantifying the proportion of HIV transmission caused by these injections in sub-Saharan Africa "difficult and unavoidably subjective." Estimates of such transmission have ranged from 2.5 percent to 30 percent or greater, depending on the risk assumed.
When this method was applied to data from rural southwest Uganda, the results showed that the higher estimates of the proportion of incidence due to injections were reduced from 15.5 percent (95 percent credible interval, 0.7 percent, 44.9 percent) to 5.2 percent (0.5 percent, 17.0 percent) if random mixing is assumed, and from 14.6 percent (0.7 percent, 42.5 percent) to 11.8 percent (1.2 percent, 32.5 percent) assortative mixing. Lower, more widely accepted estimates remained largely unchanged, from 1 percent to 3 percent (0.1-6.3 percent).
The authors noted in conclusion: "Although important uncertainty remains, our analysis shows that in rural Uganda, contaminated injections are unlikely to account for a large proportion of HIV incidence. This result is likely to be generalizable to many other populations in sub-Saharan Africa."
Proc National Acad of Sciences
06.05.2007; Vol. 104; No. 23: P. 9794-9799; Richard G. White, S. Cooper Ben, Anusha Kedhar, Kate K. Orroth, Sam Biraro, Rebecca F. Baggaley, Jimmy Whitworth, Eline L. Korenromp, Azra Ghani, Marie-Claude Boily, Richard J. Hayes
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.