Cofactors in male-female sexual transmission of human immunodeficiency virus type 1.
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.
Plummer
F A
FA
Kenya Medical Research Institute, University of Nairobi.
Simonsen
J N
JN
Cameron
D W
DW
Ndinya-Achola
J O
JO
Kreiss
J K
JK
Gakinya
M N
MN
Waiyaki
P
P
Cheang
M
M
Piot
P
P
Ronald
A R
AR
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
D003276:Contraceptives, Oral