Title: Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men.

POPLINE Document Number: 073173

Author(s):

Cameron DW
Simonsen JN
D'Costa LJ
Ronald AR
Maitha GM
Gakinya MN
Cheang M
Ndinya-Achola JO
Piot P
Brunham RC

Source citation:

Lancet, 1989 Aug 19;2(8660):403-7.

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)

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