title: Rising HIV-1 prevalence among sexually transmitted disease clinic attenders in Jamaica: traumatic sex and genital ulcers as risk factors.
abstract: Between November 1990 and January 1991, status of human immunodeficiency virus (HIV) infection was assessed for 522 men and 484 women attending the Comprehensive Health Centre in Kingston, Jamaica, for a new sexually transmitted disease (STD) complaint. Prevalence of HIV type 1 (HIV-1) infection was 3.1% (31 of 1,006), a tenfold rise in seroprevalence in 4.5 years. Nineteen of 517 (3.7%) heterosexual men, 3 of 5 (60%) homosexual/bisexual men, and 9 of 484 (1.9%) women were infected with HIV. In heterosexual men, factors associated with HIV infection after age adjustment included present complaint of genital ulcer [odds ratio (OR) 7.3; 95% confidence interval (CI) 1.4-72], past history of genital ulcer (OR, 4.3; CI, 1.4-12), positive MHATP syphilis serology (OR, 3.4; CI, 1.1-10), sex with a prostitute in the past month (OR, 3.8; CI, 1.1-11). Three or more sex partners in the month prior to complaint (OR, 3.6; CI, 1.0-12), and bruising during sex (OR, 4.0; CI, 1.4-13). On multiple logistic regression analysis, independent associations with HIV infection were shown for bruising during sex (OR, 3.0; CI, 1.1-8.3), positive MHATP syphilis serology (OR, 3.2; CI, 1.1-9.5), and history of genital ulcer (OR, 2.9; CI, 1.0-8.0).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Ministry of Health, Kingston, Jamaica.
authors.forename: J P
authors.initials: JP
authors.lastname: Figueroa
authors.forename: A
authors.initials: A
authors.lastname: Brathwaite
authors.forename: J
authors.initials: J
authors.lastname: Morris
authors.forename: E
authors.initials: E
authors.lastname: Ward
authors.forename: A
authors.initials: A
authors.lastname: Peruga
authors.forename: W
authors.initials: W
authors.lastname: Blattner
authors.forename: S H
authors.initials: SH
authors.lastname: Vermund
authors.forename: R
authors.initials: R
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000367:Age Factors; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications*; D005832:Genital Diseases, Male / Q000150:complications*; D005835:Genitalia / Q000293:injuries*; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D015497:HIV-1; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications; D014456:Ulcer