Trends in HIV infection: prevention-related attitudes and behaviors among secondary school students in western Uganda.

OBJECTIVE: To monitor trends in the attitudes and behaviors of youth in western Uganda with respect to prevention of HIV/AIDS. DESIGN: Annual data collection in a group of sentinel secondary schools in 3 districts using a short, self-administered, and anonymous questionnaire. METHODS: Fifteen secondary schools were randomly selected, and a cross-sectional survey of students was carried out each year between 1995 and 2001. All students from S (senior level) 2 to S4 were invited to complete the questionnaire. For data analysis, all completed questionnaires of students between the ages of 12 and 20 years were considered. RESULTS: In total, 6 surveys were carried out yielding 6231 valid questionnaires. Ever use of condoms among sexually active youth increased significantly from 48.8% in 1995 to 1996 to 72.8% in 2000 to 2001. Male students were more likely to report increased sexual abstinence during the time period than female students. Conversely, female students over the same time period reported having fewer sexual partners than male students. The number of sexually active students reporting sexual intercourse in the past 3 months remained the same. CONCLUSIONS: These data show that significant positive changes in the sexual behavior of secondary school students in western Uganda have occurred. This could explain, in part, the decline of HIV prevalence rates among young people observed in this region.

Infant feeding practices in western Tanzania and Uganda: implications for infant feeding recommendations for HIV-infected mothers.

Current infant feeding guidelines of UNICEF/UNAIDS/WHO for HIV-infected women recommend the avoidance of breastfeeding or to breastfeed exclusively. In the context of a prevention of HIV mother-to-child transmission programme we assessed the feeding practices in peripheral areas of Tanzania and Uganda. A total of 237 mothers in south-western Tanzania and 424 mothers in western Uganda attending urban and rural antenatal care services as well as village women were interviewed with regard to duration of breastfeeding, time of introduction of additional nutrients and type of solid and liquid nutrients. The average reported duration of breastfeeding was 24 months in Tanzania but 18 months in Uganda (P < 0.001). Solid nutrients were added on average at month 6 in both areas while liquids were given significantly earlier in Tanzania (month 4) than in Uganda (month 5; P < 0.001). A total of 19% and 48% of the study participants, respectively, stated to breastfeed their infants exclusively at the age of 4 months in Tanzania and Uganda. Age between 26 and 35 years, urban residence and ethnic group were the risk factors for earlier introduction of nutrients in Uganda. In Tanzania, solid maize porridge was the most frequent (94%) and often single nutrient given during breastfeeding, while in Uganda combinations of nutrients such as bananas, millet and beans were used. Milk was the most frequently added fluid in Uganda whereas in Tanzania various liquids such as liquid maize porridge, milk, juice or water were used. Feeding practices differed considerably in the two countries. According to the interviewees, exclusive breastfeeding was rarely practiced in Tanzania. Our findings underline the necessity to promote exclusive breastfeeding if infant feeding recommendations are to be realized and emphasize the need to assess the local situation in order to ensure that locally appropriate information and recommendations are given to the target groups.