Author(s) |
Ministry of Health, Uganda ICF International, Calverton Maryland, USA Centers for Disease Control and Prevention, Entebbe, Uganda U.S. Agency for International Development, Kampala, Uganda WHO Uganda Kampala, Uganda |
Date |
2012-08-01 |
Country |
Uganda |
Language |
English |
Description |
This report constitutes the latest, most comprehensive national HIV and AIDS information for Uganda. Information is wide ranging and includes data on HIV-related knowledge, attitudes, and behaviours, patient care, and biomarker indicators. The survey results demonstrate both the strengths and challenges of Uganda’s response. Furthermore, the results demonstrate indisputably that HIV infection remains a significant health problem for Uganda; for this reason, the report should serve as a call to action for all stakeholders. The report should be used as a resource to inform the process of planning and policy formulation as well as the monitoring and evaluation of HIV and AIDS programmes. |
Table of contents |
CONTENTS ............................................................................................................................................................... iii
TABLES AND FIGURES ........................................................................................................................................ vii
FOREWORD ..............................................................................................................................................................xi
MAP OF UGANDA .................................................................................................................................................. xii
CHAPTER 1 INTRODUCTION ........................................................................................................................... 1
1.1 Background Information ................................................................................................................... 1
1.2 Objectives of the Survey ................................................................................................................... 3
1.3 Sample Design and Implementation ................................................................................................. 4
1.4 Questionnaires ................................................................................................................................... 5
1.5 Biomarkers ........................................................................................................................................ 6
1.5.1 Blood Collection ................................................................................................................. 6
1.5.2 Home-Based Testing for HIV and Syphilis ........................................................................ 8
1.5.3 Central Laboratory Testing ................................................................................................. 9
1.5.4 Quality Control Testing .................................................................................................... 10
1.6 Training and Data Collection .......................................................................................................... 10
1.7 Data Processing ............................................................................................................................... 11
1.8 Response Rates ............................................................................................................................... 12
CHAPTER 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION .............................. 13
2.1 Household Characteristics ............................................................................................................... 13
2.1.1 Water and Sanitation ......................................................................................................... 14
2.1.2 Housing Characteristics .................................................................................................... 15
2.1.3 Household Remoteness ..................................................................................................... 17
2.1.4 Household Food Security .................................................................................................. 17
2.1.5 Household Possessions ..................................................................................................... 18
2.2 Wealth Index ................................................................................................................................... 19
2.3 Household Population by Age, Sex, and Residence ....................................................................... 20
2.4 Household Composition .................................................................................................................. 22
2.5 Birth Registration ............................................................................................................................ 22
2.6 Children’s Living Arrangements and Orphanhood ......................................................................... 23
2.7 Educational Attainment of Household Population .......................................................................... 25
CHAPTER 3 CHARACTERISTICS OF SURVEY RESPONDENTS ............................................................ 29
3.1 Background Characteristics ............................................................................................................ 29
3.2 Educational Attainment of Respondents ......................................................................................... 31
3.3 Exposure to Mass Media ................................................................................................................. 33
3.4 Employment and Occupation .......................................................................................................... 35
3.5 Marital Status .................................................................................................................................. 39
3.6 Polygyny ......................................................................................................................................... 40
3.7 Age at First Marriage ...................................................................................................................... 41
CHAPTER 4 KNOWLEDGE OF HIV AND AIDS .......................................................................................... 45
4.1 Awareness of HIV/AIDS ................................................................................................................ 45
4.2 Knowledge of Means of Preventing HIV Transmission ................................................................. 46
4.3 Knowledge of Mother-to-Child Transmission ................................................................................ 54
CHAPTER 5 ATTITUDES RELATED TO HIV/AIDS ................................................................................... 57
5.1 Accepting Attitudes towards Those Living with HIV ..................................................................... 57
5.2 Negative Attitudes towards Those Living with HIV ....................................................................... 61
5.3 Personal Knowledge of Discrimination Related to HIV/AIDS ....................................................... 63
5.4 Attitudes towards Negotiating Safer Sexual Relations ................................................................... 64
5.5 Educating Youth About Condom Use and Postponing Sex Until Marriage ................................... 66
5.6 Perceived Risk of Getting HIV ....................................................................................................... 67
CHAPTER 6 SEXUAL BEHAVIOUR ............................................................................................................... 69
6.1 Age at First Sexual Intercourse ....................................................................................................... 69
6.2 Recent Sexual Activity .................................................................................................................... 71
6.3 Multiple Sexual Partners ................................................................................................................. 73
6.4 Concurrent Sexual Partners ............................................................................................................. 77
6.5 Higher Risk Sexual Intercourse ...................................................................................................... 78
6.6 Transactional Sex ............................................................................................................................ 80
6.7 Alcohol Use during Sex .................................................................................................................. 82
6.8 Forced and Coerced Sex ................................................................................................................. 84
6.9 Prevalence of Sexually Transmitted Infections ............................................................................... 86
6.10 Prevalence of Injections .................................................................................................................. 87
CHAPTER 7 HIV AND YOUTH ........................................................................................................................ 91
7.1 Comprehensive Knowledge about HIV among Young People ....................................................... 91
7.2 Early Initiation of Sexual Intercourse ............................................................................................. 93
7.3 Condom Use at First Sexual Intercourse ......................................................................................... 94
7.4 Abstinence and Premarital Sex ....................................................................................................... 95
7.5 Multiple Sexual Partners among Youth .......................................................................................... 97
7.6 Age Differences between Sexual Partners ...................................................................................... 98
CHAPTER 8 HIV PREVALENCE ................................................................................................................... 101
8.1 Coverage Rates for HIV Testing ................................................................................................... 101
8.2 HIV Prevalence by Age and Sex ................................................................................................... 104
8.3 Trends in HIV Prevalence ............................................................................................................. 105
8.4 HIV Prevalence by Socioeconomic Characteristics ...................................................................... 106
8.5 HIV Prevalence by Demographic Characteristics ......................................................................... 109
8.6 HIV Prevalence by Sexual Behaviour ........................................................................................... 110
8.7 HIV Prevalence among Youth ...................................................................................................... 112
8.8 HIV Prevalence and Other Sexually Transmitted Infections ........................................................ 116
8.9 HIV Prevalence among Cohabiting Couples ................................................................................ 117
8.10 HIV Prevalence among Children under Age 5 .............................................................................. 119
CHAPTER 9 HIV PROGRAMME COVERAGE INDICATORS ................................................................ 123
9.1 Coverage of HIV Counseling and Testing .................................................................................... 123
9.2 HIV Counseling and Testing among Youth .................................................................................. 128
9.3 HIV Prevalence by Prior HIV Test Results .................................................................................. 129
9.4 Use of Cotrimoxazole ................................................................................................................... 131
9.5 Prior CD4 Testing Coverage ......................................................................................................... 131
9.6 CD4 Cells Test Results from the Survey ...................................................................................... 132
9.7 ARV Eligibility and Use ............................................................................................................... 132
9.8 Testing and Counseling during Pregnancy .................................................................................... 135
9.9 Male Circumcision ........................................................................................................................ 136
9.9.1 Prevalence of Male Circumcision ................................................................................... 136
9.9.2 Age and Place of Male Circumcision ............................................................................. 138
9.9.3 Attitudes about Male Circumcision ................................................................................ 139
9.9.4 HIV Prevalence and Male Circumcision ........................................................................ 140
CHAPTER 10 SYPHILIS PREVALENCE........................................................................................................ 143
10.1 Coverage Rates for Syphilis Testing ............................................................................................. 143
10.2 Syphilis Prevalence by Age and Sex ............................................................................................. 146
10.3 Trends in Syphilis Prevalence ....................................................................................................... 146
10.4 Syphilis Prevalence by Socioeconomic Characteristics ................................................................ 147
10.5 Syphilis Prevalence by Demographic Characteristics ................................................................... 148
10.6 Syphilis Prevalence by Sexual Behaviour ..................................................................................... 149
10.7 Syphilis Prevalence among Youth ................................................................................................ 150
10.8 Syphilis Prevalence by Other Characteristics ............................................................................... 152
10.8.1 Syphilis Prevalence and Other Sexually Transmitted Infections .................................... 152
10.8.2 Syphilis Prevalence and Male Circumcision .................................................................. 152
10.9 Syphilis Prevalence among Cohabiting Couples ........................................................................... 153
REFERENCES ........................................................................................................................................................ 157
APPENDIX A SAMPLE DESIGN AND IMPLEMENTATION ..................................................................... 161
A.1 Introduction ................................................................................................................................... 161
A.2 Sampling Frame ............................................................................................................................ 161
A.3 Sample Design and Selection ........................................................................................................ 163
A.4 Sample Implementation ................................................................................................................ 164
A.5 Sample Probabilities and Sample Weights .................................................................................... 168
APPENDIX B SAMPLING ERRORS ............................................................................................................... 171
APPENDIX C DATA QUALITY TABLE ......................................................................................................... 181
APPENDIX D PERSONS INVOLVED IN THE 2011 UGANDA AIDS INDICATOR SURVEY ................ 183
APPENDIX E QUESTIONNAIRES .................................................................................................................. 187 |
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