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To the Editor: The study by Dr Mermin and colleagues¹ provided data on recent HIV infection in Uganda by using the BED capture enzyme immunosorbent assay as a proxy for HIV incidence. It demonstrated that the weighted incidence of HIV infection in the region of north central Uganda was 4.7 per 100 person-years, more than double any other part of the country. Although only given brief mention in the discussion, this finding is extremely interesting and worth further attention because, as the authors note, north central Uganda (defined as the districts of Gulu, Kitgum, and Pader) has experienced war since 1986, unlike other parts of the country.

The relationship between war and HIV transmission is disputed because certain conflict settings have appeared protective,² likely through isolation of the population, whereas in other settings war appears to increase risk of HIV infection.^3-4 The lack of clarity regarding HIV transmission in conflict . . . [Full Text of this Article]

Michael Westerhaus, MD
mwesterhaus@partners.org
Brigham and Women's Hospital
Boston, Massachusetts

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