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Contribution of HIV-1 infection to acquisition of sexually transmitted disease: a 10-year prospective study.

Authors :
McClelland RS
Lavreys L
Katingima C
Overbaugh J
Chohan V
Mandaliya K
Ndinya-Achola J
Baeten JM
Source :
The Journal of infectious diseases [J Infect Dis] 2005 Feb 01; Vol. 191 (3), pp. 333-8. Date of Electronic Publication: 2004 Dec 22.
Publication Year :
2005

Abstract

Background: Sexually transmitted diseases (STDs) enhance human immunodeficiency virus (HIV)-1 susceptibility, but few studies have examined the reciprocal effect of HIV-1 on STD acquisition.<br />Methods: Data from a prospective cohort study conducted among female sex workers in Mombasa, Kenya between 1993 and 2003 were used to determine the effect of HIV-1 infection on STD susceptibility. The cohort included 1215 HIV-1-seronegative women who underwent monthly HIV-1 and STD screening, of whom 238 experienced seroconversion to HIV-1 during follow-up. Andersen-Gill proportional-hazards models were used to compare the incidence rates for genital-tract infections (syphilis, genital ulcer disease [GUD], Neisseria gonorrhoeae infection, Chlamydia trachomatis infection, Trichomonas vaginalis infection, vulvovaginal candidiasis, and bacterial vaginosis) in HIV-1-seropositive versus HIV-1-seronegative women, after controlling for sexual behavior and other potential confounding factors.<br />Results: HIV-1 infection was associated with a significantly higher incidence of GUD (hazard ratio [HR], 2.8; 95% confidence interval [CI], 2.0-3.9), gonorrhea (HR, 1.6; 95% CI, 1.1-2.2), and vulvovaginal candidiasis (HR, 1.5; 95% CI, 1.3-1.8). The risks of GUD and vulvovaginal candidiasis increased with progressive levels of immunosuppression.<br />Conclusions: The increased incidence of genital-tract infections among HIV-1-seropositive women could promote the spread of both HIV-1 and other STDs, particularly in areas where these conditions are highly prevalent.

Details

Language :
English
ISSN :
0022-1899
Volume :
191
Issue :
3
Database :
MEDLINE
Journal :
The Journal of infectious diseases
Publication Type :
Academic Journal
Accession number :
15633091
Full Text :
https://doi.org/10.1086/427262