Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa.
Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa.
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患有性传播疾病的男性中的人类免疫缺陷病毒感染。
DOI：
10.1056/nejm198808043190504
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
F. Plummer
中科院分区：
文献类型：
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作者：
J. Simonsen;Cameron Dw;Cameron Dw;Cameron Dw;Gakinya Mn;Gakinya Mn;Gakinya Mn;J. Ndinya‐Achola;J. Ndinya‐Achola;J. Ndinya‐Achola;L. D'costa;L. D'costa;L. D'costa;P. Karasira;P. Karasira;P. Karasira;M. Cheang;M. Cheang;M. Cheang;A. Ronald;A. Ronald;A. Ronald;P. Piot;P. Piot;P. Piot;F. Plummer;F. Plummer;F. Plummer
人类免疫缺陷病毒（艾滋病毒）的异性性传播似乎在非洲很容易发生，但在北美和欧洲不太常见。我们在内罗毕一家性病诊所就诊的男性中进行了一项病例对照研究，以确定艾滋病毒感染的流行率和所涉及的危险因素。在参加这项研究的340名男子中，11.2%的人检测到艾滋病毒抗体。非阴道异性性交和同性恋的报告非常罕见。最近的注射和输血与艾滋病毒感染无关。旅行和经常与妓女接触与艾滋病毒血清阳性有关。未行包皮环切术的男性更容易感染HIV（比值比，2.7; P = 0.003），报告有生殖器溃疡史的男性也是如此（比值比，7.2; P <0.001）。生殖器溃疡的当前诊断也与HIV血清阳性相关（比值比，2.0; P = 0.028）。多变量分析显示，在包皮环切术和未包皮环切术男性中，生殖器溃疡与HIV感染之间存在独立关联。未割包皮的男性更容易感染艾滋病毒，无论生殖器溃疡的历史。我们的研究发现，生殖器溃疡和完整的包皮与患有性传播疾病的男性艾滋病毒感染有关。生殖器溃疡可能会增加男性对HIV的易感性，也可能会增加感染HIV的女性的传染性。完整的包皮可能会增加对艾滋病毒的易感性。
Heterosexual transmission of the human immunodeficiency virus (HIV) appears to occur readily in Africa but less commonly in North America and Europe. We conducted a case-control study among men attending a clinic for sexually transmitted diseases in Nairobi to determine the prevalence of HIV infection and the risk factors involved. HIV antibody was detected in 11.2 percent of 340 men who enrolled in the study. Reports of nonvaginal heterosexual intercourse and homosexuality were notably rare. Recent injections and blood transfusions were not associated with HIV infection. Travel and frequent contact with prostitutes were associated with HIV seropositivity. Men who were uncircumcised were more likely to have HIV infection (odds ratio, 2.7; P = 0.003), as were those who reported a history of genital ulcers (odds ratio, 7.2; P less than 0.001). A current diagnosis of genital ulcers was also associated with HIV seropositivity (odds ratio, 2.0; P = 0.028). Multivariate analysis revealed an independent association of genital ulcers with HIV infection in both circumcised and uncircumcised men. Uncircumcised men were more frequently infected with HIV, regardless of a history of genital ulcers. Our study finds that genital ulcers and an intact foreskin are associated with HIV infection in men with a sexually transmitted disease. Genital ulcers may increase men's susceptibility to HIV, or they may increase the infectivity of women infected with HIV. The intact foreskin may operate to increase the susceptibility to HIV.