Lauryn Ursery is a PhD student in epidemiology studying at the Gillings School of Global Public Health, mentored by Dr. Ross Boyce. In rural Western Uganda, people living with HIV face unique health risks, including viral acute respiratory infections (ARIs) such as the flu. Ursery presented a study led by Dr. Emily Ciccone, on HIV-associated viral acute respiratory infections (Havarti) to better understand how common these illnesses are and how they affect this community.
The team enrolled 300 HIV-positive participants from three antiretroviral therapy clinics. To be enrolled in the study, participants had to be HIV positive, over 12 years old, presenting to one of the district’s antiretroviral therapy clinics, and able to provide consent. Once the patient was enrolled, they would complete demographic questionnaires, and we would extract medical information from their medical records. They were trained to collect their own nasal swabs and asked to contact the study team within 48 hours of flu-like symptoms, such as cough, runny nose, or headache. The team then collected swabs, followed up after 14 days (often at home), and made monthly calls to catch any missed episodes.
The cohort’s median age was 41.5, most were women, average household size was about five, and the majority owned bed nets. Notably, 91% had received at least one COVID-19 vaccine. After six months,137 participants reported 215 ARI episodes, with 56 individuals experiencing two or more.
The study found an incidence rate of 27.6 episodes per 1,000 person-weeks, higher than in some other Sub-Saharan African studies. The most common symptoms were rhinorrhea, cough, and headache, and influenza A and B were commonly detected, though many samples were negative. A clear seasonal pattern emerged: cases increased during the dry season, when flu A and B appeared more often.
By mapping where cases occurred, the team identified areas that could benefit most from targeted public health interventions, such as influenza vaccination for people living with HIV in rural communities. The next steps include deeper geographic analysis and using the findings to guide vaccination and prevention strategies.
Ultimately, this work shows how careful, community-based research can inform smarter, more targeted responses to respiratory infections among people living with HIV in rural settings.