Nasio JM, Nagelkerke NJ, Mwatha A, Moses S, Ndinya-Achola JO, Plummer FA; International Conference on AIDS.
Int Conf AIDS. 1994 Aug 7-12; 10: 41 (abstract no. 458C).
University of Nairobi, Dept of Med. Milrob, Kenya.
OBJECTIVE: To explore differences in HIV prevalence, behavioral factors and circumcision status between a group of genital ulcer disease (GUD) male patients (cases) and a group of urethritis patients (controls) attending the same STD clinic in Nairobi, Kenya. METHODS: 614 GUD patients and 201 urethritis patients were enrolled into the study. Behavioral risk factors and circumcision status were ascertained by a standard questionnaire. Specimens were collected from the base of the ulcer and the urethra for microbiological diagnosis. Serum was collected for RPR, TPHA, and HIV serology. Logistic regression was used for multivariate analysis. RESULTS: Of the 614 ulcer patients 269 were diagnosed as chancroid, 82 as syphilis and 263 as 'other ulcer'. Of ulcer patients 31% were HIV-1 positive and 77% were circumcised while among urethritis patients these percentages were 16% and 85% respectively. Their risk behaviour as regards putative source of STD were similar. Both HIV and noncircumcision were independent risk factors for GUD. DISCUSSION: Circumcision was protective against both HIV and GUD. Most STDs were reportedly acquired recently making it unlikely that HIV infection resulted from the same contact. The association between GUD and HIV therefore cannot be explained by the theory that GUD exclusively facilitates HIV transmission. Exploration of additional causal pathways may be needed to explain the impact of HIV on GUD. Alternatively much of the association between the two could be attributable to an unknown confounder which behaves similar to circumcision.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Ambulatory Care Facilities
- Chancroid
- Circumcision, Male
- Female
- Female Urogenital Diseases
- HIV Infections
- HIV Seropositivity
- Humans
- Kenya
- Male
- Peptic Ulcer
- Risk Factors
- Sexually Transmitted Diseases
- Syphilis
- Ulcer
- Urethritis
- Urogenital System
- surgery
Other ID:
UI: 102211170
From Meeting Abstracts