NON-ULCERATIVE SEXUALLY-TRANSMITTED DISEASES AS RISK-FACTORS FOR HIV-1 TRANSMISSION IN WOMEN - RESULTS FROM A COHORT STUDY
NON-ULCERATIVE SEXUALLY-TRANSMITTED DISEASES AS RISK-FACTORS FOR HIV-1 TRANSMISSION IN WOMEN - RESULTS FROM A COHORT STUDY
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DOI：
10.1097/00002030-199301000-00015
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发表时间：
1993-01-01
期刊：
影响因子：
3.8
通讯作者：
PIOT, P
中科院分区：
文献类型：
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作者：
LAGA, M;MANOKA, A;PIOT, P
目标：HIV-1的异性性传播在世界不同地区以不同的速度发生。每次性接触传播HIV-1的概率很低，但可能会被几个辅助因素大大提高。性传播疾病（STD），特别是生殖器溃疡，可能是这样的因素。到目前为止，其他性传播疾病促进HIV-1传播的流行病学证据还很薄弱。本研究的目的是确定是否可治疗的性病增强性传播的HIV-1的一个队列中的妓女在金沙萨，Zaia.Methods：我们进行了巢式病例对照研究，431最初HIV-1阴性的妇女前瞻性的平均持续时间为2年（每月性病检查和3个月的HIV-1血清学）。病例（血清转换者，n = 68）与对照组（妇女谁仍然是HIV-1阴性，n = 126）的发病率和性暴露在假定期间的HIV-1收购。结果：在这个队列的HIV-1的年发病率为9.8%。血清转换者比HIV-1阴性女性年轻（平均年龄，24.6岁对26.8岁; P = 0.04）。在HIV-1感染期间，淋病、衣原体感染和滴虫病的发病率明显高于对照组，与嫖客和伴侣发生无保护性行为的频率也高于对照组。通过多变量分析控制性暴露后，淋病、衣原体感染和滴虫病的血清转换校正比值比分别为4.8（95%置信区间（CI），2.4-9.8）、3.6（95% CI，1.4-9.1）和1.9（95% CI，0.9-4.1）。生殖器溃疡的情况下，比对照组更频繁，但远低于常见的比其他STD。结论：非溃疡性STD的性传播的HIV-1的妇女，控制性暴露后的危险因素。由于非溃疡性STD在某些人群中的高患病率，它可能是全球HIV-1传播的一个相当大的人群归因风险。将可治疗的性传播疾病确定为HIV-1传播的危险因素，为预防艾滋病毒/艾滋病提供了一项重要的补充战略。
Objectives: The heterosexual spread of HIV-1 is occurring at different rates in different parts of the world. The transmission probability of HIV-1 per sexual contact is low, but may be greatly enhanced by several cofactors. Sexually transmitted diseases (STD), especially genital ulcers, may be such factors. So far, epidemiological evidence that other STD facilitate HIV-1 transmission is weak. The objective of this study was to determine whether treatable STD enhanced sexual transmission of HIV-1 in a cohort of female prostitutes in Kinshasa, Zaire.Methods: We conducted a nested case-control study of 431 initially HIV-1-negative women followed prospectively for a mean duration of 2 years (with monthly STD check-ups and 3-monthly HIV-1 serology). Cases (seroconverters, n = 68) were compared with controls (women who remained HIV-1-negative, n = 126) for incidence of STD and sexual exposure during the presumed period of HIV-1 acquisition.Results: The annual incidence of HIV-1 in this cohort was 9.8%. Seroconverters were younger than HIV-1-negative women (mean age, 24.6 versus 26.8 years; P = 0.04). During the period of HIV-1 acquisition, cases had a much higher incidence of gonorrhoea, chlamydial infection and trichomoniasis, and engaged in unprotected sex with clients and partners more frequently than controls. After controlling for sexual exposure by multivariate analysis, adjusted odds ratios for seroconversion were 4.8 [95% confidence interval (Cl), 2.4-9.8] for gonorrhoea, 3.6 (95% Cl, 1.4-9.1) for chlamydial infection and 1.9 (95% Cl, 0.9-4.1) for trichomoniasis. Genital ulcers were more frequent in cases than controls, but much less common than other STD.Conclusion: Non-ulcerative STD were risk factors for sexual transmission of HIV-1 in women, after controlling for sexual exposure. Because of their high prevalence in some populations, non-ulcerative STD may represent a considerable population-attributable risk in the transmission of HIV-1 worldwide. The identification of treatable STD as risk factors for HIV-1 transmission offers an important additional strategy for the prevention of HIV/AIDS.