About the Study
A prospective cohort study to assess feasibility of enrolling and retaining at risk adolescents aged 14 to 19 years from hotspots in Kampala, Uganda.This project is part of the European and Developing Countries Clinical Trials Partnership (EDCTP2) programme supported by the European Union
FERDAR is a cohort study among 14-19 years old adolescents at risk of HIV infection. The study is enrolling female and male adolescents from commercial hotspots and slums in Kampala, Uganda and assessing a number of epidemiological outcomes.
- Field workers mobilized participants through peer leaders and community mobilization. Quantitative data on socio-demographics, behavior, sexual and reproductive health was collected using interviewer administered questionnaires while qualitative data was collected using focus group discussions (FGDs) and in-depth interviews (IDIs).
- Three focus group discussions have been conducted among females and two among males to collect qualitative data on facilitators and barriers to participation in HIV prevention research and attitudes and perceptions towarsd on-demand PrEP. In addition 50 in-depth interviews were conducted to further explore these topics and data analysis is on-going. Associations with substance use and intimate partner violence were analysed by gender using logistic regression analysis while qualitative data is being analysed using thematic analysis.
Community meetings are held to educate adolescents about HIV prevention and importance of other prevention services such as oral pre-exposure prophylaxis for HIV, screening and treatment for sexually transmitted infections and vaccination for Hepatitis B. These meetings are also used to remind enrolled volunteers to continue their follow up visist in the study.
- Since the beginning of the project, we have screened 704 participants (416 females and 288 males). Of these 297 females and 193 males have been enrolled bringing the total number enrolled to 490. Results from study outcomes are as follows: •
- Current HIV prevalence is 2.2%. Females 3.4% (10/297) and males 0.5% (1/193). We have recorded 3 incident HIV infections among females and none among males. The proportion reporting ≥10 sexual partners in the past 3 months is 43.1% (females) and 37.8% (males). •
- Baseline STI prevalence among 490 enrolled participants (chlamydia, gonorrhoea and active syphilis) is 30.6% among females and 14.5% among males. We are still collecting follow up data for females and are not able to give estimates for STI incidence in the current report. •
- Contraceptive prevalence among enrolled female participants is 59.2%. The common methods being used are implants and injectable contraceptives. •
- Illicit drug use among enrolled volunteers is 61.7% among males and 17.5% among females; the most common drugs being marijuana and khat. Alcohol misuse is determined using the alcohol use disorder identification tests (AUDIT). The prevalence of alcohol use at baseline is higher among females than in males (60.9% vs 41.5%). •
- Reports of all forms of intimate partner violence (IP) are higher among females than males as follws: physical violence (37.4% vs 14.5%), sexual violence (31.6% vs 7.8%) and emotional violence (41.4% vs 22.3%); 23.9% of females and 11.4% of males report experiencing more than one type of violence. •
- Females had higher odds of experiencing IPV as compared to males (OR: 3.17, 95% CI: 2.17-4.64). Also, the odds of being alcohol consumers were higher for females when compared to males (OR: 2.20, 95% CI: 1.52-3.18), however females had lower odds of usingillicit drugs when compared to males (OR: 0.14, 95% CI: 0.09-0.21).
Preliminary findings from this adolescent cohort indicate that they continue to be at risk of HIV infection given high number of sexual partners and STI prevalence; they engage in substance use and experience IPV, which have health and social economic consequences at both the individual and societal level. Interventions targeting substance use reduction, IPV should target female and male adolescents.
Dr Yunia Mayanja
Senior Behavioural Scientist &co-investigator
jane .f. Lunkuse
Senor Data Manager
Social Science Interviewer
IT Systems Administrator
Other Memebrs working closely with Ferdar study team
Data managment Assistant