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Rising HIV-1 prevalence in STD clinic attenders in Jamaica: Traumatic sex and genital ulcers as risk factors

Rising HIV-1 prevalence in STD clinic attenders in Jamaica: Traumatic sex and genital ulcers as risk factors
Rising HIV-1 prevalence in STD clinic attenders in Jamaica: Traumatic sex and genital ulcers as risk factors
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). Among women, history of "bad blood" (syphilis) (OR, 6.6; CI, 1.4-30), self-perception of high risk for acquired immune deficiency syndrome (AIDS) (OR, 8.6; CI, 0.9-108), positive gonorrhea culture (OR 12; CI 2.1-72), HTLV-1 seropositivity (OR, 5.7; CI, 0.9-29), history of stillbirth (OR, 7.6; CI, 1.3-43), and current abnormality of the cervix (OR, [infinity]; CI, 1.7-[infinity]) were associated with HIV infection. Conditions giving rise to a disruption of the genital epithelium in men such as bruising (trauma) with sex and genital ulcers may facilitate HIV transmission from women to men while inflammation of the cervix (e.g., gonorrhea) may facilitate male-to-female HIV transmission
2155-6113
310-316
Figueroa, J.P.
98aaa99a-173b-4bba-be78-b5ea46d85bb2
Braithwaite, A.
dfaff376-dcbc-4d24-831f-4052257c4a49
Morris, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Ward, E.
92107261-5906-4e12-8868-a771661650a3
Peruga, A.
7e344756-6817-427d-bee5-05365a0d52b9
Blattner, W.
38afd3d3-d633-4a9d-af01-7c242f910897
Vermund, S.H.
17268028-ec9b-4db3-b546-411084469440
Hayes, R.
1e72f202-76cd-4bad-ac5a-570925e9004e
Figueroa, J.P.
98aaa99a-173b-4bba-be78-b5ea46d85bb2
Braithwaite, A.
dfaff376-dcbc-4d24-831f-4052257c4a49
Morris, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Ward, E.
92107261-5906-4e12-8868-a771661650a3
Peruga, A.
7e344756-6817-427d-bee5-05365a0d52b9
Blattner, W.
38afd3d3-d633-4a9d-af01-7c242f910897
Vermund, S.H.
17268028-ec9b-4db3-b546-411084469440
Hayes, R.
1e72f202-76cd-4bad-ac5a-570925e9004e

Figueroa, J.P., Braithwaite, A., Morris, J.S., Ward, E., Peruga, A., Blattner, W., Vermund, S.H. and Hayes, R. (1994) Rising HIV-1 prevalence in STD clinic attenders in Jamaica: Traumatic sex and genital ulcers as risk factors. Journal of Acquired Immune Deficiency Syndromes, 7 (3), 310-316.

Record type: Article

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). Among women, history of "bad blood" (syphilis) (OR, 6.6; CI, 1.4-30), self-perception of high risk for acquired immune deficiency syndrome (AIDS) (OR, 8.6; CI, 0.9-108), positive gonorrhea culture (OR 12; CI 2.1-72), HTLV-1 seropositivity (OR, 5.7; CI, 0.9-29), history of stillbirth (OR, 7.6; CI, 1.3-43), and current abnormality of the cervix (OR, [infinity]; CI, 1.7-[infinity]) were associated with HIV infection. Conditions giving rise to a disruption of the genital epithelium in men such as bruising (trauma) with sex and genital ulcers may facilitate HIV transmission from women to men while inflammation of the cervix (e.g., gonorrhea) may facilitate male-to-female HIV transmission

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Published date: 1994
Organisations: Faculty of Health Sciences

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Local EPrints ID: 365125
URI: https://eprints.soton.ac.uk/id/eprint/365125
ISSN: 2155-6113
PURE UUID: 11a47d07-4988-4a7d-9212-dda05d1885c5

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Date deposited: 29 May 2014 11:05
Last modified: 18 Jul 2017 02:24

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Contributors

Author: J.P. Figueroa
Author: A. Braithwaite
Author: J.S. Morris
Author: E. Ward
Author: A. Peruga
Author: W. Blattner
Author: S.H. Vermund
Author: R. Hayes

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