title: Cofactors in male-female sexual transmission of human immunodeficiency virus type 1.
abstract: In a study of human immunodeficiency virus type 1 (HIV-1)-uninfected African prostitutes, 83 (67%) of 124 seroconverted to HIV-1. Oral contraceptive use (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1-8.6; P less than .03), genital ulcers (mean annual episodes, 1.32 +/- 0.55 in seroconverting women vs. 0.48 +/- 0.21 in seronegative women; P less than .02) and Chlamydia trachomatis infections (OR, 3.6; CI, 1.3-11.0; P less than .02) were associated with increased risk of HIV-1 infection. Condom use reduced the risk of HIV-1 infection (OR, 0.11; CI, 0.05-0.27; P less than .0001). Stepwise logistic regression analysis confirmed independent associations between HIV-1 infection and oral contraceptive use, condom use, genital ulcers, and C. trachomatis. The presence of other sexually transmitted diseases may in part explain the heterosexual HIV-1 epidemic in Africa and may represent important targets for intervention to control HIV-1 infection.
authors.affiliation: Kenya Medical Research Institute, University of Nairobi.
authors.forename: F A
authors.initials: FA
authors.lastname: Plummer
authors.forename: J N
authors.initials: JN
authors.lastname: Simonsen
authors.forename: D W
authors.initials: DW
authors.lastname: Cameron
authors.forename: J O
authors.initials: JO
authors.lastname: Ndinya-Achola
authors.forename: J K
authors.initials: JK
authors.lastname: Kreiss
authors.forename: M N
authors.initials: MN
authors.lastname: Gakinya
authors.forename: P
authors.initials: P
authors.lastname: Waiyaki
authors.forename: M
authors.initials: M
authors.lastname: Cheang
authors.forename: P
authors.initials: P
authors.lastname: Piot
authors.forename: A R
authors.initials: AR
authors.lastname: Ronald
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000150:complications; D002692:Chlamydia trachomatis; D015331:Cohort Studies; D003275:Contraceptive Devices, Male; D003276:Contraceptives, Oral; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000150:complications; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D011477:Sex Work; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology / Q000635:transmission*; D014456:Ulcer / Q000150:complications
chemical_list: D003276:Contraceptives, Oral