EPIDEMIOLOGY OF ORAL HIV 1 & 2 INFECTION IN HIGH RISK WO

描述：（改编自申请人摘要）HIV通过 口腔-生殖器接触现已得到令人信服的记录。感染艾滋病毒风险 在无保护的口腔生殖器性交期间的传播似乎较低， 在无保护的阴道性交中遇到的。然而，口腔的真正风险 艾滋病毒的传播一直难以评估，因为个人相对较少 只进行口交试图估计这种风险 使用HIV血清转化作为终点将是极其昂贵的， 存在伦理问题。需要其他方法来评估口腔疾病的各个方面。 艾滋病毒传播。制定艾滋病毒教育和减少风险方案 与口服艾滋病毒传播有关的问题目前很重要，因为最近的数据显示， 表明在一些高危人群中， (such如无保护的肛交或阴道性交）使无保护的口交 非常普遍，可能会增加艾滋病毒感染的比例， 这些人群归因于口生殖器性接触。发展 关于艾滋病病毒经口传播风险的教育项目迫在眉睫 在非洲，大多数艾滋病毒感染发生在非洲， 商业性工作者（CSW）是HIV-1传播不可或缺的一部分， HIV-2.很少有人知道的频率和决定因素的fellation和 它与艾滋病毒感染风险的关系。然而，调查人员的一项调查显示， 在塞内加尔出现艾滋病毒-1流行病期间进行的调查显示， 大多数CSM经常进行阴道性交和口交。一些CSW在 塞内加尔已经参加了艾滋病毒检测和咨询项目， 这些节目强调口交而不是阴道性交。的 调查人员正在塞内加尔的CSW中进行一项研究， 口交在HIV-1和HIV-2传播中的作用。具体而言，他们建议（1） 描述性工作者口交的频率和决定因素， 在以前没有接受过艾滋病毒检测或参加过 艾滋病毒风险降低计划，以确定艾滋病毒之间的关联 血清学状态和口交和其他性行为，（2）提供见解 艾滋病毒从受感染的CSW传播给未受感染的男性伴侣的风险 在口交过程中，通过描述频率和数量的决定因素， 艾滋病病毒通过口腔分泌物传播，（3）进行小型试验 一项旨在降低口腔分泌物中艾滋病毒感染频率和水平的研究 通过使用低成本的局部治疗已知与 炎症

DESCRIPTION: (Adapted from Applicant's Abstract) Transmission of HIV via oral-genital contact has now been convincingly documented. Risk of HIV transmission during unprotected oral-genital sex appears to be low compared to that encountered during unprotected vaginal sex. However, the true risk of oral HIV transmission has been difficult to assess as relatively few individuals engage exclusively in oral sexual contact. Attempting to estimate this risk using HIV seroconversion as an endpoint would be prohibitively expensive and present ethical problems. Other approaches are needed to assess aspects of oral HIV transmission. Development of HIV education and risk reduction programs related to oral HIV transmission are currently important since recent data suggest that in some high risk groups, attempts to decrease high risk behaviors (such as unprotected anal or vaginal sex) have made unprotected oral sex exceedingly common, perhaps increasing the proportion of HIV infections in these populations attributable to orogenital sexual contact. Development of educational programs concerning risk of oral HIV transmission is urgently needed in Africa where the majority of HIV infections have occurred, and where commercial sex workers (CSWs) have been integral to the spread of HIV-1 and HIV-2. Little is known about the frequency and determinants of fellation and its relationship to risk of HIV infection. However, a survey the investigators undertook during the emergence of the HIV-1 epidemic in Senegal revealed that most CSMs frequently engaged in both vaginal sex and fellatio. Some CSWs in Senegal have enrolled in HIV testing and counseling programs and it is possible that such programs have stressed fellatio in lieu of vaginal sex. The investigators are proposing a study among CSWs in Senegal to examine the role of fellatio in the spread of HIV-1 and HIV-2. Specifically, they propose to (1) describe the frequency and determinants of the practice of fellatio among CSWs, and among CSWs who have not been previously tested for HIV or been enrolled in HIV risk reduction programs, to determine the associations between HIV serologic status and fellatio and other sexual practices, (2) provide insights into risk of transmission of HIV from infected CSWs to uninfected male partners during fellatio by describing the determinants of the frequency and quantity with which HIV is shed into oral secretions, and (3) undertake a small pilot study to attempt to decrease the frequency and level of HIV in oral secretions by using low cost topical treatments for lesions known to be associated with inflammation.