HIV dynamics and prevention: Rakai Project Uganda.

In 1988 the Rakai Project was initiated to study the dynamics of the spread of HIV infection in Rakai and to evaluate the effect of AIDS education and counseling on the transmission of HIV infection. This study included a series of three surveys. On December 1988-March 1989 the initial survey was conducted to evaluate the knowledge attitude and practices of the cohort members. Second and third follow-up surveys were conducted in January-July 1990 and 1991 respectively. From the districts 780 resistance committees (RCs) 744 in rural villages and 36 in trading centers 840 households with 3405 individuals in 21 clusters were included in the first survey. In the 1990 follow-up the participants increased to 7000 individuals in 31 clusters with 1860 households. The results indicated that there was high knowledge of AIDS among men and town dwellers; high HIV infection rate among those aged 13 and above; condom use was 1.7% among adults and was higher in trading centers; but a gap of knowledge about HIV incubation period was observed. There were two areas of activities that comprised the projects AIDS prevention campaign: 1) community health education and condom promotion; and 2) counseling program to facilitate behavior change. The Rakai Project is first of a kind that could serve as a model program for the Ministry of Health in evaluating the impact of health education.