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1994-08-27
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Document 0670
DOCN M9480670
TI Recent changes in the epidemiology of genital ulcer disease in the
United States. The crack cocaine connection.
DT 9410
AU Martin DH; DiCarlo RP; Louisiana State University School of Medicine,
New Orleans.
SO Sex Transm Dis. 1994 Mar-Apr;21(2 Suppl):S76-80. Unique Identifier :
AIDSLINE MED/94317088
AB The incidence of syphilis and chancroid began to increase in the United
States among heterosexuals in the mid-1980s, with most cases reported
among minorities living in Eastern cities and in the South. A number of
studies have established a link between increasing syphilis incidence
rates and cocaine use, specifically the smoked form of the drug, which
is known as crack. A similar link was hypothesized for chancroid, but
supporting data became available only recently. In New Orleans, we
showed that Haemophilus ducreyi infection in male patients was strongly
associated with crack cocaine use. However, our studies also
demonstrated that drug use by the patient actually was a marker for a
more important risk factor: sexual exposure to a cocaine-using woman.
Thus, although the details of the relationships among crack, sexual
behavior, and the size and nature of core transmitter groups are not
known, it is clear that crack cocaine abuse is the driving force behind
the recent syphilis and chancroid epidemics in the United States.
Although it is not possible to predict the effects of these events on
human immunodeficiency virus (HIV) transmission, the potential for
significant synergism between them exists. New approaches to HIV
surveillance should be developed taking this possibility into account.
During the last 3 to 4 years, incidence rates of syphilis and chancroid
have fallen in the United States, despite continued problems throughout
the country with crack cocaine abuse. However, our studies and those of
others have shown how difficult it is to recognize chancroid clinically,
suggesting that the disease may be grossly underreported.(ABSTRACT
TRUNCATED AT 250 WORDS)
DE Chancroid/*EPIDEMIOLOGY/*ETIOLOGY/TRANSMISSION *Crack Cocaine Female
Human HIV Infections/*EPIDEMIOLOGY/*ETIOLOGY/TRANSMISSION Incidence
Male Minority Groups *Population Surveillance Primary
Prevention/METHODS Risk Factors Sex Behavior Substance
Dependence/*COMPLICATIONS Syphilis/*EPIDEMIOLOGY/*ETIOLOGY/TRANSMISSION
United States/EPIDEMIOLOGY JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).