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M9480642.TXT
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1994-08-20
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Document 0642
DOCN M9480642
TI Seroconversion in patients attending sexually transmitted disease
clinics.
DT 9410
AU Kassler WJ; Zenilman JM; Erickson B; Fox R; Peterman TA; Hook EW 3rd;
Division of STD/HIV Prevention, Centers for Disease Control,; Atlanta,
GA 30333.
SO AIDS. 1994 Mar;8(3):351-5. Unique Identifier : AIDSLINE MED/94304556
AB OBJECTIVES: To characterize recent HIV seroconverters in a sexually
transmitted disease (STD) clinic population, and examine changing
transmission patterns. METHODS: We conducted a case-control study nested
within a retrospectively defined cohort of individuals attending
Baltimore STD clinics between January 1988 and July 1990.
Seroconverters, who tested HIV-positive after having a negative test,
were compared to both HIV-negative controls, who were also tested twice,
and a second, prevalent HIV-positive control group. Controls were
matched 2:1 by sex, clinic, and month of HIV test. RESULTS: Forty-nine
out of 6175 (0.79%) patients tested at least twice had documented HIV-1
seroconversion. On multivariate analysis, seroconversion was
significantly associated with self-reported injecting drug use [odds
ratio (OR), 7.3; 95% confidence interval (CI), 2.3-23)], with being a
man who has had sex with other men (OR, 3.5%; 95% CI, 1.2-10), or with
having sex with a known HIV-infected person (OR, 11; 95% CI, 1.3-96).
Thirty-five per cent of seroconverters did not report a risk for HIV
infection, and a higher proportion of recent seroconverters also
reported no risk. Compared to the prevalent positive control group, more
seroconverters reported no risk and a lower proportion reported
recognized risks. A diagnosis of gonorrhea was also significantly
associated with seroconversion (OR, 2.5; 95% CI, 1.1-5.7). CONCLUSIONS:
These data suggest increasing heterosexual transmission of HIV in this
inner-city STD clinic population. Incident STD, in particular gonorrhea,
may increase a patient's risk for HIV infection, suggesting that
patients with STD should be targeted aggressively for HIV prevention
activities.
DE Adult Ambulatory Care Facilities Baltimore/EPIDEMIOLOGY Case-Control
Studies Cohort Studies Female Gonorrhea/COMPLICATIONS Human HIV
Infections/PREVENTION & CONTROL/TRANSMISSION HIV
Seropositivity/*COMPLICATIONS/*EPIDEMIOLOGY *HIV-1 Male Multivariate
Analysis Retrospective Studies Risk Factors Sexually Transmitted
Diseases/*COMPLICATIONS Substance Abuse, Intravenous/COMPLICATIONS
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).