Date of Award

Fall 1-8-2016

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Richard Rothenberg

Second Advisor

Dr. Matt Hayat

Abstract

Background:

Presently, the region that disproportionally carries the highest burden of the HIV1 and HSV2 epidemic is SSA (sub-Saharan Africa). Uganda, a country in Sub-Saharan Africa, Uganda has both high incidence of HIV1 and high prevalence of HSV2 infection. Recent statistics demonstrate a 22% increase in HIV1 incidence from 2001 to 2011 in Uganda. A segment of this population in Uganda is composed of female sex workers (FSWs) who in Uganda account for 35 percent of the nation's HIV1 prevalence. This study explores a population of male partners and clients of these female sex workers (MPCSWs) in order to identify potential risk factors that this segment of the sex work population may contribute to HIV1 and HSV2 prevalence in the sex work population in Kampala, Uganda.

Methods:

Data was obtained from the 2008/2009 Crane Survey and collection of clinical data was completed with the collaboration of Uganda Ministry of Health STD/AIDS Control Programme, Makerere University School of Public Health, and the Centers for Disease Control and Prevention. Four multiple logistic regression models were built with the ten chosen independent variables to identify associations among these variables and each of the four cross-classified serostatuses of HIV1 and HSV2. The level of significance of all analyses was α=.05.

Results:

Having a presence of a genital ulcer/sore in the last 12 months was found to have significant association with cross-classified serostatuses HIV1-, HSV2- (OR: 0.52) and HIV1+, HSV2+ (OR: 2.29). Reporting "ever been married" was found to have significant association with cross-classified serostatuses HIV1-, HSV2- (OR: 0.52), HIV1+, HSV2- (OR: 2.90). The variable "age" was found to have significance with cross-classified serostatuses HIV1-,HSV2- (OR: 0.90), HIV1-, HSV2+ (OR: 1.06), and HIV1+, HSV2+ (OR: 1.08). Lastly, those that reported having had a circumcision had significant associations with cross-classified serostatuses HIV1+, HSV2- (OR: 0.26) and HIV1+, HSV2+ (OR: 0.48).

Conclusion:

Although significant associations were not established across all cross-classified serostatuses for all variables found to have at least one significant association with a cross-classified serostatus, previous evidence provides support for these type of observational studies with similar survey structures to have compromised statistical power and possibly explain for why within significant variables, significant associations were not found across all outcome groups. Circumcision status and the presence of a genital ulcer/sore in the last 12 months appears to have possible important implications with acquiring both these infections, especially HIV-1 for the studied population.

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