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To the Editor: Dr Mermin and colleagues¹ reported results from the nationally representative survey conducted in Uganda in 2004, showing an overall HIV prevalence of 6.35%. The BED assay was then applied to this cross-sectional study to identify recent HIV infections to give an estimated incidence of 1.8 per 100 person-years and a prevalence-to-incidence ratio of 3.3:1. In another study of a rural population of 18 000 from Masaka in 2004, the HIV prevalence was 7.7%, similar to the national estimate, but incidence was 0.5 per 100 person-years, giving a prevalence-to-incidence ratio of 15.4:1.²

An HIV incidence of 1.8 per 100 person-years in a population with an HIV prevalence of 6.35% suggests that average survival following HIV infection is much shorter than that currently observed in Uganda and elsewhere in Africa. The alternative explanation of a dramatic increase in HIV incidence in Uganda would not be consistent with observations from the . . . [Full Text of this Article]

Jim Todd, MSc
jim.todd@mrcuganda.org
Medical Research Council/Uganda Virus Research Institute  (MRC/UVRI) Uganda Research Unit on AIDS

Tom Lutalo, MSc
Rakai Health Sciences Program

Pontiano Kaleebu, PhD
MRC/UVRI Uganda Research Unit on AIDS
Entebbe, Uganda

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