title: HIV-1 seroconversion in patients with and without genital ulcer disease. A prospective study.
abstract: 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.
authors.affiliation: New York City Department of Health, New York.
authors.forename: E E
authors.initials: EE
authors.lastname: Telzak
authors.forename: M A
authors.initials: MA
authors.lastname: Chiasson
authors.forename: P J
authors.initials: PJ
authors.lastname: Bevier
authors.forename: R L
authors.initials: RL
authors.lastname: Stoneburner
authors.forename: K G
authors.initials: KG
authors.lastname: Castro
authors.forename: H W
authors.initials: HW
authors.lastname: Jaffe
mesh_terms: 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