The impact of AIDS in a rural Ugandan community

Three AIDS related surveys have been conducted on a community based cohort in the Kasangati defined area, Uganda, during 1987, 1990 and 1992. The 1987 baseline survey recruited 1990 adults, and in addition to assessing levels of knowledge, attitudes and practices, HIV serology was done on all the study participants. During the 1992 survey, our objectives were threefold: (i) to assess the attitudes and behaviours relevant to AIDS and to evaluate the magnitude of any changes since 1987, (ii) to assess the socioeconomic impact of AIDS and, (iii) to assess the effect of AIDS on the mortality trends in the area. It was found that the percentage of people who had ever used a condom increased from 4% in 1987 to 10% in 1992, but those who used condoms frequently remained the same at 1%. Sexual partner change was measured over a six month period and the percentage of people who had two or more sexual partners in this period was found to be 7% in 1992 compared to 26.4% in 1987. The five year mortality rate among the persons initially HIV positive was 44.7% compared to 8.7% among those initially sero-negative. AIDS has substantially increased the mortality rate in this community leading to reduced incomes for the families of persons dying from the disease, increased expenditure on medical treatment, and a new breed of orphans. The overall five year mortality rate was 10.6% (128/1204) but if the persons reported to have died from AIDS are excluded it is only 6.1% (73/1204).