ABSTRACT
Objective: The paper examines the role of the rural marketing system in the spread of HIV infection in Rakai District. Implications for public health interventions are discussed. Methods: Medical-anthropological data (qualitative and quantitative) from a 13 month field study (1992-93) are presented. Results: A complex system of mobile rural markets which rotate around the district on a regular basis and bring large urban traders into contact with rural populations is identified. Three types of markets serve as centers of commerce and social activity. (1) Large markets of cattle; marchandise; and produce draw pastorilists and others into contact with highly infected traders from urban areas. These markets move to 4 different locations bi-weekly. Considerable socialising occurs in the evenings when people spend the night at the market sites. (2) Intermediate markets move to 6 different locations biweekly and are attended by smaller traders who sell goods purchased in (1). (3) Smaller rural markets are open daily and attended by villagers and traders from (1) and (2). The markets also serve as meeting places for adolescents and young adults. Sexual activity is common. Conclusion: the marketing system appears to play a significant role as a vehicle for HIV transmission from urban to rural trading centers and remote villages. Public health interventions need to be designed for the rural