| 1. Peer Reviewed Title: Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Author: Cameron DW; Simonsen JN; D'Costa LJ; Ronald AR; Maitha GM; Gakinya MN; Cheang M; Ndinya-Achola JO; Piot P; Brunham RC Source: Lancet. 1989 Aug 19;2(8660):403-7. Presented to the American Society for Clinical Investigation, Washington, May, 1988, and the 4th International Conference on AIDS, Stockholm, June, 1988 Abstract: To determine the frequency and risk factors for female to male sexual transmission of human immunodeficiency virus type 1 (HIV-1), a prospective study was carried out on 422 men who had acquired a sexually transmitted disease (STD) from a group of prostitutes with a prevalence of HIV-1 infection of 85%. The initial seroprevalence of HIV among the men was 12%; 24 of 293 (8.2%) initially seronegative men seroconverted to HIV-1. Newly acquired infection was independently associated with frequent prostitute contact (risk ratio 3.2, 95% confidence interval 1.2-8.1), with the acquisition of genital ulcer disease (risk ration 4.7, 95% confidence interval 1.2-17.0), and with being uncircumcised (risk ration 8.2, 95% confidence interval 3.0-23.0). 96% of documented seroconversions occurred in men with 1 or both of the latter 2 risk factors. In a subgroup of 73 seronegative men who reported a single prostitute sexual contact, the frequency of HIV-1 infection was 8.2% during 12 weeks of observation. No man without a genital ulcer seroconverted. A cumulative 43% of uncircumcised men who acquired an ulcer seroconverted to HIV-1 after a single sexual exposure. These data indicate an extremely high rate of female to male transmission of HIV-1 in the presence of STD and confirm a causal relation between lack of male circumcision, genital ulcer disease, and susceptibility to HIV-1 infection. (author's) Language: English Keywords: KENYA | HIV TRANSMISSION | HETEROSEXUALS | PROSPECTIVE STUDIES | SEX WORKERS | MULTIPLE PARTNERS | MALE CIRCUMCISION | GENITAL EFFECTS, MALE | GENITAL EFFECTS, FEMALE | SEX FACTORS | RISK FACTORS | COHORT ANALYSIS | STATISTICAL REGRESSION | AIDS | EPIDEMIOLOGIC METHODS | POPULATION AT RISK | HIV INFECTIONS | INCIDENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SEXUALLY TRANSMITTED DISEASES | HIV TESTING | TRANSMISSION | WOMEN | STATISTICAL STUDIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Sex Behavior | Behavior | Studies | Research Methodology | Sexual Partners | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Genitalia, Female | Population Characteristics | Demographic Factors | Population | Data Analysis | Measurement | Examinations and Diagnoses | Reproductive Tract Infections | Infections Document Number: 073173 |
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