HIV-1 subtype E incidence and sexually transmitted diseases in a cohort of military conscripts in northern Thailand.
OBJECTIVE
To determine the rate of and risk factors for HIV-1 seroconversion and describe sexually transmitted disease (STD) prevalence rates for young men in northern Thailand.


METHODS
Data were collected from self-administered questionnaires and serologic testing at enrollment in a prospective study in 1991 and at follow-up after 6, 17, and 23 months on a cohort of 1115 men selected by lottery for military conscription.


RESULTS
A total of 14 men seroconverted to HIV-1 envelope subtype E. The overall HIV-1 incidence rate was 1.1 (95% confidence interval [CI], 0.6-1.8) per 100 person-years (PY) of follow-up. However, the rate was 2.0/100 PY for conscripts from the upper northern subregion of Thailand compared with 0.5/100 PY from other regions (adjusted rate ratio [RR] = 2.69; 95% CI, 0.8-12.2). On multivariate analyses, the behavioral factors associated with HIV-1 seroconversion were frequency of sex with female sex workers (FSWs; p = .04), receptive anal sex (adjusted RR = 6.73; 95% CI, 1.8-21.7), and large amount of alcohol consumption (adjusted RR = 3.12; 95% CI, 1.0-10.9). Genital ulceration was the STD most strongly associated with seroconversion. The prevalence of serologic reactivity to syphilis, Haemophilus ducreyi, and herpes simplex virus type 2 increased with greater frequency of sex with FSWs and was generally higher for men from the upper north.


CONCLUSIONS
Young men in northern Thailand are at high risk for HIV-1, primarily through sex with FSWs; and other STDs are highly associated with HIV-1 incidence. As HIV-1 infection extends into the general population, intervention programs are needed to address the problem of sexual transmission apart from commercial sex venues.
Nopkesorn
T
T
Royal Thai Third Army, Phitsanuloke.
Mock
P A
PA
Mastro
T D
TD
Sangkharomya
S
S
Sweat
M
M
Limpakarnjanarat
K
K
Laosakkitiboran
J
J
Young
N L
NL
Morse
S A
SA
Schmid
S
S
Weniger
B G
BG
D000328:Adult; D000428:Alcohol Drinking; D002602:Chancroid / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D015497:HIV-1 / Q000145:classification / Q000276:immunology; D006561:Herpes Simplex / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D013587:Syphilis / Q000453:epidemiology / Q000209:etiology; D013785:Thailand / Q000453:epidemiology
D015483:HIV Antibodies