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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Understanding the socio-structural context of high HIV transmission in kasensero fishing community, South Western Uganda

BMC Public Health > Ausgabe 1/2015
Muhamadi Lubega, Neema Nakyaanjo, Sumaya Nansubuga, Edgar Hiire, Godfrey Kigozi, Gertrude Nakigozi, Tom Lutalo, Fred Nalugoda, David Serwadda, Ronald Gray, Maria Wawer, Caitlin Kennedy, Steven James Reynolds
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

ML, NN, SN and SJR were involved in all the processes for the study from concept, design, data collection, analysis and interpretation of the findings. All the other authors contributed significantly to the data analysis and manuscript writing and intellectual content for the study. All authors read and approved the final manuscript.



In Kasensero fishing community, home of the first recorded case of HIV in Uganda, HIV transmission remains high with an incidence of 4.3 and 3.1 per 100 person-years in women and men, respectively, and an HIV prevalence of 44 %, reaching up to 74 % among female sex workers. We explored the social contextual factors for the high HIV transmission at Kasensero to inform future policy and preventive interventions.


We conducted 20 in-depth interviews, including both HIV positive and HIV negative respondents, and 12 focus-group discussions involving a total of 92 respondents from the Kasensero fishing community from April-September 2014. Content analysis was performed to identify recurrent themes.


Our findings suggest that the high HIV transmission in Kasensero is a complex function of eight themes including; positive/negative attitudes about HIV and combination HIV prevention such as the demand for services versus ART/circumcision disinhibition; HIV depository; Multiple partners; Frequent unprotected sex; Clothing; Parental behaviors; Pressure within the sex industry; and Cross generational sex.


The current combination HIV prevention services by the RHSP need to be enhanced with more government involvement including ensuring sustainable supply of ART and circumcision services since they are reportedly highly demanded. Community involvement through the engagement of popular peers could also help in the campaign to change the HIV predisposing culture, misconceptions and risky social norms of the population.
Social Context HIV Transmission Fishing Community.
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