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AIDS Research and Human Retroviruses

HIV Type 1 Subtype Distribution, Multiple Infections, Sexual Networks, and Partnership Histories in Female Sex Workers in Kampala, Uganda

To cite this article:
Deogratius Ssemwanga, Nicaise Ndembi, Fred Lyagoba, Justine Bukenya, Janet Seeley, Judith Vandepitte, Heiner Grosskurth, and Pontiano Kaleebu. AIDS Research and Human Retroviruses. March 2012, 28(4): 357-365. doi:10.1089/aid.2011.0024.

Published in Volume: 28 Issue 4: March 28, 2012
Online Ahead of Print: August 21, 2011
Online Ahead of Editing: July 13, 2011

Author information

Deogratius Ssemwanga,1 Nicaise Ndembi,1 Fred Lyagoba,1 Justine Bukenya,1 Janet Seeley,1,2,3 Judith Vandepitte,1 Heiner Grosskurth,1,2 and Pontiano Kaleebu1,2
1MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
2London School of Hygiene and Tropical Medicine, London, United Kingdom.
3School of International Development, University of East Anglia, Norwich, United Kingdom.
Address correspondence to:
Pontiano Kaleebu
MRC/UVRI Uganda Research Unit on AIDS
Plot 51-59 Nakiwogo Road
P.O. Box 49
Entebbe
Uganda
E-mail:

ABSTRACT

We investigated for the first time the subtype distribution, prevalence of multiple HIV-1 infections, sexual networks, and partnership histories in a cohort of women engaged in high-risk sexual behavior such as female sex workers (FSWs) and women employed in entertainment facilities. Viral RNA was extracted from blood samples collected from 324 HIV-1-positive women; the gp-41 and pol-IN genes were directly sequenced. Women found to have closely related viruses and those with recombinant viruses were further analyzed in the pol-IN gene by clonal sequencing to determine HIV-1 multiple infections. Individual partnership histories were used to provide information on when sex work was undertaken and where. Subtyping in both gp-41 and pol-IN was successfully done in 210/324 (64.8%) women. Subtype distribution in these two genes was 54.3% (n=114) A/A, 2.9% (n=6) C/C, 24.3% (n=51) D/D, 11.9% (n=25) A/D, 4.8% (n=10) D/A, 0.5% (n=1) C/A, 1.0% (n=2) B/A, and 0.5% (n=1) B/D. Sexual networks were identified in six pairs and one triplet of women with closely related subtype A viruses. Partnership histories showed that women having phylogenetically similar viruses had worked in the same localities. Five cases of multiple infections were confirmed: four dual infections and one triple infection. In this first molecular epidemiology study among FSWs in Kampala, subtype A was the predominant subtype. About 9% of a subgroup had multiple infections. Partnership histories and multiple infections observed in this population suggest sexual mixing of the FSWs and their clients confirming their high-risk characteristics.

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