Feasibility of establishing an HIV vaccine preparedness cohort in a population of the Uganda Police Force: Lessons learnt from a prospective study

• Published in: PloS one Vol. 15; no. 4; p. e0231640
• Main Authors: Bahemuka, Ubaldo Mushabe, Abaasa, Andrew, Seeley, Janet, Byaruhanga, Moses, Kamali, Anatoli, Mayaud, Philippe, Kuteesa, Monica
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 17.04.2020; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; AIDS Vaccines - administration & dosage; Alcohol use; Armed forces; Biology and Life Sciences; Community; Confidence intervals; Councils; Counseling; Feasibility Studies; Female; Follow-Up Studies; Health risks; Healthy Volunteers; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - transmission; Human immunodeficiency virus; Humans; Hygiene; Identification methods; Incidence; Infections; Laboratories; Male; Medical research; Medical tests; Medicine; Medicine and Health Sciences; Middle Aged; Military; People and Places; Police; Police - statistics & numerical data; Police departments; Population; Pre-Exposure Prophylaxis - organization & administration; Pre-Exposure Prophylaxis - statistics & numerical data; Program Evaluation; Prospective Studies; Recruitment; Regression analysis; Regression models; Retention; Risk Factors; Risk management; Risk reduction; Seroconversion; Sexually transmitted diseases; Social Sciences; Statistical analysis; STD; Studies; Syphilis; Uganda - epidemiology; Ulcers; Vaccination - methods; Vaccination - statistics & numerical data; Vaccines; Young Adult; Uganda; New York; United Kingdom > UK; United States > US; Japan; Africa; Tanzania; Kampala Uganda; East Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0231640

Members of uniformed armed forces are considered to be at high risk for HIV infection and have been proposed as suitable candidates for participation in HIV intervention studies. We report on the feasibility of recruitment and follow up of individuals from the community of the Uganda Police Force (UPF) for an HIV vaccine preparedness study. HIV-negative volunteers aged 18-49 years, were identified from UPF facilities situated in Kampala and Wakiso districts through community HIV counselling and testing. Potential volunteers were referred to the study clinic for screening, enrolment and quarterly visits for one year. HIV incidence, retention rates were estimated and expressed as cases per 100 person years of observation (PYO). Rate ratios were used to determine factors associated with retention using Poisson regression models. We screened 560 to enroll 500 volunteers between November 2015 and May 2016. One HIV seroconversion occurred among 431 PYO, for an incidence rate of 0.23/100 PYO (95% confidence interval [CI]: 0.03-1.64). Overall, retention rate was 87% at one year, and this was independently associated with residence duration (compared to <1 year, 1 to 5 years adjusted rate ratio (aRR) = 1.19, 95%CI: 1.00-1.44); and >5 years aRR = 1.34, 95%CI: 0.95-1.37); absence of genital discharge in the last 3 months (aRR = 1.97, 95% CI: 1.38-2.83, absence of genital ulcers (aRR = 1.90, 95%CI: 1.26-2.87, reporting of new sexual partner in the last month (aRR = 0.57, 95%CI: 0.45-0.71, being away from home for more than two nights (aRR = 1.27, 95%CI: 1.04-1.56, compared to those who had not travelled) and absence of knowledge on HIV prevention (aRR = 2.67, 95%CI: 1.62-4.39). While our study demonstrates the feasibility of recruiting and retaining individuals from the UPF for HIV research, we did observe lower than anticipated HIV incidence, perhaps because individuals at lower risk of HIV infection may have been the first to come forward to participate or participants followed HIV risk reduction measures. Our findings suggest lessons for recruitment of populations at high risk of HIV infection.