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.
Source Information
Department of Medical Microbiology, University of Nairobi, Kenya.
This article has been cited by other articles:
Chudnovsky, A., Niederberger, C. S.
(2007). The Foreskin Dilemma: To Cut or Not to Cut. J Androl
28: 5-7
[Full Text]
Fergusson, D. M., Boden, J. M., Horwood, L. J.
(2006). Circumcision Status and Risk of Sexually Transmitted Infection in Young Adult Males: An Analysis of a Longitudinal Birth Cohort. Pediatrics
118: 1971-1977
[Abstract][Full Text]
Weiss, H A, Thomas, S L, Munabi, S K, Hayes, R J
(2006). Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis.. Sex. Transm. Infect.
82: 101-110
[Abstract][Full Text]
Van Howe, R. S, Svoboda, J S., Hodges, F. M
(2005). HIV infection and circumcision: cutting through the hyperbole. The Journal of the Royal Society for the Promotion of Health
125: 259-265
[Abstract]
Stevceva, L., Alvarez, X., Lackner, A. A., Tryniszewska, E., Kelsall, B., Nacsa, J., Tartaglia, J., Strober, W., Franchini, G.
(2002). Both Mucosal and Systemic Routes of Immunization with the Live, Attenuated NYVAC/Simian Immunodeficiency Virus SIVgpe Recombinant Vaccine Result in Gag-Specific CD8+ T-Cell Responses in Mucosal Tissues of Macaques. J. Virol.
76: 11659-11676
[Abstract][Full Text]
Schoen, E. J., Wiswell, T. E., Moses, S.
(2000). New Policy on Circumcision---Cause for Concern. Pediatrics
105: 620-623
[Full Text]
Schoen, E. J., Oehrli, M., Machin, G.
(2000). The Highly Protective Effect of Newborn Circumcision Against Invasive Penile Cancer. Pediatrics
105: 36e-36
[Abstract][Full Text]
Singh, A. E., Romanowski, B.
(1999). Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features. Clin. Microbiol. Rev.
12: 187-209
[Abstract][Full Text]
Task Force on Circumcision,
(1999). Circumcision Policy Statement. Pediatrics
103: 686-693
[Abstract][Full Text]
Cameron, C. E., Castro, C., Lukehart, S. A., Van Voorhis, W. C.
(1998). Function and Protective Capacity of Treponema pallidum subsp. pallidum Glycerophosphodiester Phosphodiesterase. Infect. Immun.
66: 5763-5770
[Abstract][Full Text]
Schoen;, E. J, HITCHCOCK, R.
(1997). Benefits of newborn circumcision: is Europe ignoring medical evidence? • Commentary. Arch. Dis. Child.
77: 258-260
[Full Text]
Fleiss, P. M., Robson, L. M., Leung, A. K.C., Van Howe, R. S., Weiss, G.
(1995). A Perspective on Controversies About Neonatal Circumcision. CLIN PEDIATR
34: 395-399
Horowitz, C. R., Jackson, J. C., Teklemariam, M., Schoen, E. J., Buff, D. D., Weydert, J.-M., Fleiss, P. M., Gilson, G. J., Toubia, N.
(1995). Female Circumcision. NEJM
332: 188-190
[Full Text]
Chessare, J. B.
(1992). Circumcision: Is the Risk of Urinary Tract Infection Really the Pivotal Issue?. CLIN PEDIATR
31: 100-104
[Abstract]
Previous
