Prevalence of HIV infection and bacteriologically confirmed tuberculosis among individuals found at bars in Kampala slums, Uganda

Joseph Baruch Baluku,Robert Buyungo,Godwin Anguzu,Sharon Namiiro,Irene Andia-Biraro,Mike Sempiira,Sylvia Nassozi,Febronius Babirye,Amir Wasswa,Rose Mulwana,Samuel Ntambi,William Worodria

doi:10.1038/s41598-020-70472-6

Joseph Baruch Baluku, Robert Buyungo + Show 10 more

Open Access

https://doi.org/10.1038/s41598-020-70472-6

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Abstract

Individuals found at bars in slums have several risk factors for HIV and tuberculosis (TB). To determine the prevalence of HIV and TB among individuals found at bars in slums of Kampala, Uganda, we enrolled adults found at bars that provided written informed consent. Individuals with alcohol intoxication were excluded. We performed HIV testing using immunochromatographic antibody tests (Alere Determine HIV-1/2 and Chembio HIV 1/2 STAT-PAK). TB was confirmed using the Xpert MTB/RIF Ultra assay, performed on single spot sputum samples. We enrolled 272 participants from 42 bars in 5 slums. The prevalence of HIV and TB was 11.4% (95% CI 8.1–15.8) and 15 (95% CI 6–39) per 1,000 population respectively. Predictors of HIV were female sex (aOR 5.87, 95% CI 2.05–16.83), current cigarette smoking (aOR 3.23, 95% CI 1.02–10.26), history of TB treatment (aOR 10.19, 95% CI 3.17–32.82) and CAGE scores of 2–3 (aOR 3.90, 95% CI 1.11–13.70) and 4 (aOR 4.77, 95% CI 1.07–21.35). The prevalence of HIV and TB was twice and four times the national averages respectively. These findings highlight the need for concurrent programmatic screening for both HIV and TB among high risk populations in slums.

Highlights

HIV and tuberculosis (TB) interact at an epidemiological, clinical, cellular, and molecular level to create a coepidemic[1]
We screened 342 potential participants found at bars in Kampala slums
In a multivariable logistic regression model, female sex (adjusted odds ratio 5.87, 95% confidence interval (CI) 2.05–16.83), current cigarette smoking, history of TB treatment and CAGE scores of 2–3 and 4 independently predicted HIV infection

Summary

Introduction

HIV and tuberculosis (TB) interact at an epidemiological, clinical, cellular, and molecular level to create a coepidemic[1]. It is likely that the prevalence of HIV among bar customers, employees and neighbours of bars in slums is high due to the high risk sexual behaviour, low risk perception of sex with commercial sex workers and inconsistent condom use observed among individuals at bars in slums[21,25,26]. Individuals who attend bars are less likely to visit health facilities and new TB cases and HIV infections among customers, staff and residents at bars in slums are missed[12].

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