HIV-1 seroconversion in patients with and without genital ulcer disease. A prospective study.
OBJECTIVE
To determine the relative risk for human immunodeficiency virus (HIV-1) seroconversion in patients with and without genital ulcers caused by chancroid, syphilis, and herpes.


METHODS
A prospective cohort study.


METHODS
An inner-city, sexually transmitted disease clinic.


METHODS
Patients seronegative for HIV-1 with and without genital ulcers who were followed for a minimum of 3 months.


METHODS
Questionnaire to obtain data on demographics, sexual behavior, and illicit drug use; testing for HIV-1 at entry and at a minimum of 3 months after entry; medical examination for the presence or absence of genital ulcer disease.


RESULTS
Overall, 758 heterosexual men with no history of injection drug use completed the study; HIV-1 seroconversion occurred in 10 of 344 (2.9%; 95% CI, 1.4% to 5.3%) men with a genital ulcer and in 4 of 414 (1%; CI, 0.2% to 2.5%) without a genital ulcer (relative risk, 3.0; P = 0.05). In a multiple logistic regression analysis, those men with chancroid and a new sexually transmitted disease during follow-up each had about three times the risk for HIV-1 seroconversion (P < or = 0.04).


CONCLUSIONS
In this group of heterosexual men, chancroid and repeated acquisition of sexually transmitted diseases appeared to facilitate the sexual transmission of HIV-1.
Telzak
E E
EE
New York City Department of Health, New York.
Chiasson
M A
MA
Bevier
P J
PJ
Stoneburner
R L
RL
Castro
K G
KG
Jaffe
H W
HW
D000328:Adult; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications* / Q000209:etiology; D005832:Genital Diseases, Male / Q000150:complications* / Q000209:etiology; D006679:HIV Seropositivity / Q000150:complications / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000150:complications*; D019966:Substance-Related Disorders / Q000150:complications; D014456:Ulcer / Q000150:complications / Q000209:etiology