The epidemiology of HIV-1 in a rural Uganda population

HIV infection and AIDS are currently among the most pressing global public health issues. The World Health Organization estimates that since the beginning of the pandemic in the late 1970s to the end of 1994 a total of 18 million adults and 1.5 million children had become infected with HIV, 11 million cases in Africa alone. In Uganda, the first cases of clinical AIDS were recognised in 1982 in the Rakai district situated in the South-West of the country. By the end of 1988 a cumulative total of about 6,750 AIDS cases had been reported to the Ministry of Health; the majority of cases were residents of Kampala I the capital, and Rakai and neighbouring Masaka districts. There is little doubt that the reported number is a considerable underestimate of the actual figure. Available data on the HIV seroprevalence in adults living in Kampala suggested that the level increased from about 10% in 1985 to 18% in 1988. In 1988 adult seroprevalence levels were of the order of 1% in some rural villages in Northern Uganda and 30% or more in some villages in South-West Uganda. Thus, a major HIV epidemic was emerging.