Understanding the Socio-Structural Context of High HIV Transmission in Kasensero Fishing Community, South Western Uganda

In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission remains high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44 %, reaching up to 74 % among female sex workers. We explored the social contextual factors for the high HIV transmission at Kasensero to inform future policy and preventive interventions.

We conducted 20 in-depth interviews, including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community from April-September 2014. Content analysis was performed to identify recurrent themes.

Our findings suggest that the high HIV transmission in Kasensero is a complex function of eight themes including; positive/negative attitudes about HIV and combination HIV prevention such as the demand for services versus ART/circumcision disinhibition; HIV depository; Multiple partners; Frequent unprotected sex; Clothing; Parental behaviors; Pressure within the sex industry; and Cross generational sex.

The current combination HIV prevention services by the RHSP need to be enhanced with more government involvement including ensuring sustainable supply of ART and circumcision services since they are reportedly highly demanded. Community involvement through the engagement of popular peers could also help in the campaign to change the HIV predisposing culture, misconceptions and risky social norms of the population.

Full article at: http://goo.gl/ZX7xNS

By: 

Muhamadi Lubega^1234*, Neema Nakyaanjo¹, Sumaya Nansubuga³, Edgar Hiire¹, Godfrey Kigozi¹, Gertrude Nakigozi¹, Tom Lutalo¹, Fred Nalugoda¹, David Serwadda¹, Ronald Gray¹⁵, Maria Wawer¹⁵, Caitlin Kennedy⁵ and Steven James Reynolds¹⁴⁵

¹Rakai Health Sciences Program, Old Bukoba road, Kalisizo, Uganda

²Division of Global Health, IHCAR, Department of Public Health Sciences, Karolinsika Institutet, Stockholm, Sweden

³School of Graduate Studies and Research Busoga University, Iganga, Uganda

⁴Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

⁵Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA

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