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A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda.
AIDS. 1998 Jul 09; 12(10):1211-25.AIDS

Abstract

OBJECTIVE

To describe the design and first-round survey results of a trial of intensive sexually transmitted disease (STD) control to reduce HIV-1 incidence.

STUDY DESIGN

Randomized, controlled, community-based trial in Rakai District, Uganda.

METHODS

In this ongoing study, 56 communities were grouped into 10 clusters designed to encompass social/sexual networks; clusters within blocks were randomly assigned to the intervention or control arm. Every 10 months, all consenting resident adults aged 15-59 years are visited in the home for interview and sample collection (serological sample, urine, and, in the case of women, self-administered vaginal swabs). Sera are tested for HIV-1, syphilis, gonorrhea, chlamydia, trichomonas and bacterial vaginosis. Following interview, all consenting adults are offered directly observed, single oral dose treatment (STD treatment in the intervention arm, anthelminthic and iron-folate in the control arm). Treatment is administered irrespective of symptoms or laboratory testing (mass treatment strategy). Both arms receive identical health education, condom and serological counseling services.

RESULTS

In the first home visit round, the study enrolled 5834 intervention and 5784 control arm subjects. Compliance with interview, sample collection and treatment was high in both arms (over 90%). Study arm populations were comparable with respect to sociodemographic and behavioral characteristics, and baseline HIV and STD rates. The latter were high: 16.9% of all subjects were HIV-positive, 10.0% had syphilis, and 23.8% of women had trichomonas and 50.9% had bacterial vaginosis.

CONCLUSIONS

Testing the effects of STD control on AIDS prevention is feasible in this Ugandan setting.

Authors+Show Affiliations

Columbia University, New York, New York, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9677171

Citation

Wawer, M J., et al. "A Randomized, Community Trial of Intensive Sexually Transmitted Disease Control for AIDS Prevention, Rakai, Uganda." AIDS (London, England), vol. 12, no. 10, 1998, pp. 1211-25.
Wawer MJ, Gray RH, Sewankambo NK, et al. A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda. AIDS. 1998;12(10):1211-25.
Wawer, M. J., Gray, R. H., Sewankambo, N. K., Serwadda, D., Paxton, L., Berkley, S., McNairn, D., Wabwire-Mangen, F., Li, C., Nalugoda, F., Kiwanuka, N., Lutalo, T., Brookmeyer, R., Kelly, R., & Quinn, T. C. (1998). A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda. AIDS (London, England), 12(10), 1211-25.
Wawer MJ, et al. A Randomized, Community Trial of Intensive Sexually Transmitted Disease Control for AIDS Prevention, Rakai, Uganda. AIDS. 1998 Jul 9;12(10):1211-25. PubMed PMID: 9677171.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda. AU - Wawer,M J, AU - Gray,R H, AU - Sewankambo,N K, AU - Serwadda,D, AU - Paxton,L, AU - Berkley,S, AU - McNairn,D, AU - Wabwire-Mangen,F, AU - Li,C, AU - Nalugoda,F, AU - Kiwanuka,N, AU - Lutalo,T, AU - Brookmeyer,R, AU - Kelly,R, AU - Quinn,T C, PY - 1998/7/24/pubmed PY - 1998/7/24/medline PY - 1998/7/24/entrez KW - Acquired Immunodeficiency Syndrome--prevention and control KW - Africa KW - Africa South Of The Sahara KW - Comparative Studies KW - Developing Countries KW - Diseases KW - Eastern Africa KW - English Speaking Africa KW - Hiv Infections--prevention and control KW - Infections KW - Measurement KW - Prevalence KW - Reproductive Tract Infections KW - Research Methodology KW - Research Report KW - Sexually Transmitted Diseases--prevention and control KW - Studies KW - Study Design KW - Treatment KW - Uganda KW - Viral Diseases SP - 1211 EP - 25 JF - AIDS (London, England) JO - AIDS VL - 12 IS - 10 N2 - OBJECTIVE: To describe the design and first-round survey results of a trial of intensive sexually transmitted disease (STD) control to reduce HIV-1 incidence. STUDY DESIGN: Randomized, controlled, community-based trial in Rakai District, Uganda. METHODS: In this ongoing study, 56 communities were grouped into 10 clusters designed to encompass social/sexual networks; clusters within blocks were randomly assigned to the intervention or control arm. Every 10 months, all consenting resident adults aged 15-59 years are visited in the home for interview and sample collection (serological sample, urine, and, in the case of women, self-administered vaginal swabs). Sera are tested for HIV-1, syphilis, gonorrhea, chlamydia, trichomonas and bacterial vaginosis. Following interview, all consenting adults are offered directly observed, single oral dose treatment (STD treatment in the intervention arm, anthelminthic and iron-folate in the control arm). Treatment is administered irrespective of symptoms or laboratory testing (mass treatment strategy). Both arms receive identical health education, condom and serological counseling services. RESULTS: In the first home visit round, the study enrolled 5834 intervention and 5784 control arm subjects. Compliance with interview, sample collection and treatment was high in both arms (over 90%). Study arm populations were comparable with respect to sociodemographic and behavioral characteristics, and baseline HIV and STD rates. The latter were high: 16.9% of all subjects were HIV-positive, 10.0% had syphilis, and 23.8% of women had trichomonas and 50.9% had bacterial vaginosis. CONCLUSIONS: Testing the effects of STD control on AIDS prevention is feasible in this Ugandan setting. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/9677171/A_randomized_community_trial_of_intensive_sexually_transmitted_disease_control_for_AIDS_prevention_Rakai_Uganda_ L2 - http://Insights.ovid.com/pubmed?pmid=9677171 DB - PRIME DP - Unbound Medicine ER -