title: Incidence and predictors of human immunodeficiency virus type 1 seroconversion in patients attending sexually transmitted disease clinics in India.
abstract: The first estimates of the seroincidence of human immunodeficiency virus type 1 (HIV-1) and of the risk factors for seroconversion in a cohort of high-risk patients attending sexually transmitted disease (STD) clinics in India are reported. Between 1993 and 1995, 851 HIV-1-seronegative persons were evaluated prospectively every 3 months for HIV infection and biologic and behavioral characteristics. The overall incidence of HIV-1 was 10.2/100 person-years (95% confidence interval, 7.9-13.1). The incidence among commercial sex workers (CSWs) was 26.1/100 person-years, compared with 8.4 among non-CSWs. Recurrent genital ulcer disease and urethritis or cervicitis during the follow-up period were independently associated with a 7- (P < .001) and 3-fold (P = .06) increased risk of HIV-1 seroconversion, respectively. Because of the association of recurrent ulcerative and nonulcerative STDs with HIV-1 seroconversion in this setting, behavioral and biologic measures directed at the prevention and control of STDs would be expected to greatly reduce the transmission of HIV-1 infection in similar high-risk groups.
authors.affiliation: National AIDS Research Institute, B. J. Medical College, Pune, India.
authors.forename: S M
authors.initials: SM
authors.lastname: Mehendale
authors.forename: J J
authors.initials: JJ
authors.lastname: Rodrigues
authors.forename: R S
authors.initials: RS
authors.lastname: Brookmeyer
authors.forename: R R
authors.initials: RR
authors.lastname: Gangakhedkar
authors.forename: A D
authors.initials: AD
authors.lastname: Divekar
authors.forename: M R
authors.initials: MR
authors.lastname: Gokhale
authors.forename: A R
authors.initials: AR
authors.lastname: Risbud
authors.forename: R S
authors.initials: RS
authors.lastname: Paranjape
authors.forename: M E
authors.initials: ME
authors.lastname: Shepherd
authors.forename: A E
authors.initials: AE
authors.lastname: Rompalo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000150:complications