Evidence map›Paper›PMID 36400088›Full record

ArticleThe Lancet. Global health2022

The HIV and sexually transmitted infection syndemic following mass scale-up of combination HIV interventions in two communities in southern Uganda: a population-based cross-sectional study.

M Kate Grabowski, Josephine Mpagazi, Stephen Kiboneka, Robert Ssekubugu, John Baptiste Kereba, Annet Nakayijja, Julius Tukundane, Jade C Jackson, Austin D Peer, Caitlin Kennedy and 14 more

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Article in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors.

M Kate GrabowskiDepartment of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda. Electronic address: mgrabow2@jhu.edu.
Josephine MpagaziRakai Health Sciences Program, Kalisizo, Uganda.
Stephen KibonekaRakai Health Sciences Program, Kalisizo, Uganda.
Robert SsekubuguRakai Health Sciences Program, Kalisizo, Uganda.
John Baptiste KerebaRakai Health Sciences Program, Kalisizo, Uganda.
Annet NakayijjaRakai Health Sciences Program, Kalisizo, Uganda.
Julius TukundaneRakai Health Sciences Program, Kalisizo, Uganda.
Jade C JacksonDepartment of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Austin D PeerJohns Hopkins University School of Medicine, Baltimore, MD, USA.
Caitlin KennedyDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda.
Godfrey KigoziRakai Health Sciences Program, Kalisizo, Uganda.
Ronald M GaliwangoRakai Health Sciences Program, Kalisizo, Uganda.
Yukari C ManabeDepartment of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Larry W ChangDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Sarah KalibalaRakai Health Sciences Program, Kalisizo, Uganda.
Ronald H GrayDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda.
Maria J WawerDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda.
Steven J ReynoldsDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA; Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MA, USA.
Aaron A R TobianDepartment of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
David SerwaddaRakai Health Sciences Program, Kalisizo, Uganda; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
Charlotte A GaydosDepartment of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Joseph KagaayiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.
Thomas C QuinnDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Rakai Health Sciences Program, Kalisizo, Uganda; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA; Laboratory of Immunoregulation, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MA, USA.
Rakai Health Sciences Program

Funding

LC: HIV Prevention Trials Network - Laboratory Support for the SARS-CoV-2 Seroprevalence Study (CoVPN 5002)UM1AI068613 · NIAID · JOHNS HOPKINS UNIVERSITY · PI SUSAN H ESHLEMAN, Mark A Marzinke · 2011 to 2026
$100.2M
Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
Structural and Social Transitions Among Adolescents in Rakai (SSTAR)R01HD091003 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SANTELLI, JOHN S. · 2017 to 2021
$3.7M
RCT to reduce HIV acquisition and viral load among migrants, Rakai, UgandaR01MH115799 · NIMH · JOHNS HOPKINS UNIVERSITY · PI CHANG, LARRY WILLIAM, WAWER, MARIA J · 2018 to 2022
$2.9M
CHWs, mHealth, and Combination HIV Prevention in a Hotspot: A Randomized TrialR01MH107275 · NIMH · JOHNS HOPKINS UNIVERSITY · PI CHANG, LARRY WILLIAM · 2015 to 2019
$2.7M
Long-term impact of universal treatment and dolutegravir on population HIV virologic and incidence outcomes in Africa: The LONGVIEW StudyR01AI155080 · NIAID · JOHNS HOPKINS UNIVERSITY · PI GRABOWSKI, MARY KATHRYN · 2021 to 2024
$2.5M
Hard-to-Reach Populations: Implications for Ending the AIDS EpidemicR01AI143333 · NIAID · JOHNS HOPKINS UNIVERSITY · PI CHANG, LARRY WILLIAM · 2019 to 2022
$2.4M
Multidisciplinary Research Training to Understand and Reduce HIV Incidence in UgandaD43TW010557 · FIC · JOHNS HOPKINS UNIVERSITY · PI CHANG, LARRY WILLIAM · 2018 to 2022
$1.6M
Revealing women's hidden role as critical components of HIV transmission networks in Rakai, Uganda: an interdisciplinary approachK01AI125086 · NIAID · JOHNS HOPKINS UNIVERSITY · PI GRABOWSKI, MARY KATHRYN · 2016 to 2020
$638k
FIC NIH HHS D43 TW010557NIAID NIH HHS K01 AI125086NIAID NIH HHS P30 AI094189NIAID NIH HHS R01 AI143333NIAID NIH HHS R01 AI155080NIAID NIH HHS UM1 AI068613NICHD NIH HHS R01 HD091003NIMH NIH HHS R01 MH107275NIMH NIH HHS R01 MH115799PEPFAR
6 · The paper itself

Abstract

backgroundCombination HIV prevention and treatment interventions (CHIs) have led to substantial declines in HIV incidence in sub-Saharan Africa; however, population-level data on non-HIV sexually transmitted infections (STIs) in the context of CHIs are rare. We aimed to assess STI burden following scale-up of CHIs in Uganda.

methodsThe Sexually Transmitted Infection Prevalence Study (STIPS) was a cross-sectional study nested within a population-based cohort among inland agrarian and Lake Victoria fishing populations in southern Uganda. STIPS enrolled consenting residents aged 18-49 years in two communities (one inland and one fishing) between May and October, 2019, and measured the prevalence of chlamydia, gonorrhoea, trichomonas, syphilis, and herpes simplex virus 2 (HSV-2).

findingsBetween May 27, 2019 and Oct 25, 2019, STIPS enrolled 1825 participants. HIV prevalence was 14·0% among the inland population and 39·8% among the fishing population, with about 90% HIV viral load suppression in both communities. Among inland and fishing populations, chlamydia prevalence was 9·6% (95% CI 7·9-11·7) and 9·9% (8·1-12·0), gonorrhoea prevalence 5·0% (3·8-6·7) and 8·4% (6·8-10·5), trichomonas prevalence 9·4% (7·7-11·5) and 12·2% (10·2-14·5), and HSV-2 prevalence 43·0% (39·9-46·3) and 64·4% (61·3-67·6), respectively. In the fishing population, syphilis seropositivity was 24·2% (21·5-27·2) with 9·4% (7·7-11·5) having high-titre (rapid plasma reagin ≥1:8) infection, including 16·9% (11·9-24·0%) of men living with HIV. Prevalence of at least one curable STI (chlamydia, gonorrhoea, trichomonas, or high-titre syphilis) was 51% higher among people living with HIV (vs HIV negative; adjusted prevalence risk ratio [PRR] 1·51; 95% CI 1·27-1·78), including among pregnant women (adjusted PRR 1·87, 1·11-3·17), with no differences by HIV suppression status.

interpretationDespite near universal HIV treatment, STI burden remains extremely high in southern Uganda, particularly among people living with HIV. There is an urgent need to integrate STI care with HIV services in African settings.

fundingNational Institutes of Health.

Indexed as

GonorrheaHIV InfectionsSexually Transmitted DiseasesSyphilisTrichomonas InfectionsCross-Sectional StudiesFemaleHumansMalePregnancySyndemicUgandaUnited States

Identifiers

PMID36400088
PMCPMC10068679

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