BACKGROUND: Recently there has been a rise in genital ulcer disease (GUD) in urban minority heterosexuals in the United States. The impact of these increased GUD rates on HIV transmission patterns in this population is unknown. METHODS: Sexually transmitted disease (STD) diagnoses were correlated with HIV antibody status and risk factor history in 194 patients who consented to HIV testing at an STD clinic in central Brooklyn. RESULTS: Of 36 HIV-positive patients, 23 (64%) denied HIV risk factors other than heterosexual contact with persons of unknown HIV status. HIV antibody was associated with GUD (odds radio [OR] = 2.72, 95% confidence interval [CI] = 1.20-6.24), multiple concurrent STDs (OR = 2.51, 95% CI = 1.08-5.81), and a history of crack cocaine use (OR = 2.98, 95% CI = inexact-9.61). Crack use was also associated with GUD (OR = 15.15, 95% CI = 3.27-inexact) and multiple simultaneous STDs (OR = 13.87, 95% CI = 4.62-inexact). In a log-linear model analysis, HIV infection was independently associated with GUD and crack use. HIV infection, genital ulcer disease, and crack cocaine use were more common in women than men. CONCLUSIONS: The association between HIV infection and GUD seen here may be secondary to high-risk sexual behavior, which in turn may be partially attributable to crack cocaine use and drug-related prostitution. The high rate of coinfection with HIV and GUD raises a concern about the increased efficiency of sexual transmission of HIV in this population.
BACKGROUND: Recently there has been a rise in genital ulcer disease (GUD) in urban minority heterosexuals in the United States. The impact of these increased GUD rates on HIV transmission patterns in this population is unknown. METHODS: Sexually transmitted disease (STD) diagnoses were correlated with HIV antibody status and risk factor history in 194 patients who consented to HIV testing at an STD clinic in central Brooklyn. RESULTS: Of 36 HIV-positive patients, 23 (64%) denied HIV risk factors other than heterosexual contact with persons of unknown HIV status. HIV antibody was associated with GUD (odds radio [OR] = 2.72, 95% confidence interval [CI] = 1.20-6.24), multiple concurrent STDs (OR = 2.51, 95% CI = 1.08-5.81), and a history of crack cocaine use (OR = 2.98, 95% CI = inexact-9.61). Crack use was also associated with GUD (OR = 15.15, 95% CI = 3.27-inexact) and multiple simultaneous STDs (OR = 13.87, 95% CI = 4.62-inexact). In a log-linear model analysis, HIV infection was independently associated with GUD and crack use. HIV infection, genital ulcer disease, and crack cocaine use were more common in women than men. CONCLUSIONS: The association between HIV infection and GUD seen here may be secondary to high-risk sexual behavior, which in turn may be partially attributable to crack cocaine use and drug-related prostitution. The high rate of coinfection with HIV and GUD raises a concern about the increased efficiency of sexual transmission of HIV in this population.
Authors: T C Quinn; D Glasser; R O Cannon; D L Matuszak; R W Dunning; R L Kline; C H Campbell; E Israel; A S Fauci; E W Hook Journal: N Engl J Med Date: 1988-01-28 Impact factor: 91.245
Authors: M Carael; P H Van de Perre; P H Lepage; S Allen; F Nsengumuremyi; C Van Goethem; M Ntahorutaba; D Nzaramba; N Clumeck Journal: AIDS Date: 1988-06 Impact factor: 4.177
Authors: D W Cameron; J N Simonsen; L J D'Costa; A R Ronald; G M Maitha; M N Gakinya; M Cheang; J O Ndinya-Achola; P Piot; R C Brunham Journal: Lancet Date: 1989-08-19 Impact factor: 79.321
Authors: J K Kreiss; D Koech; F A Plummer; K K Holmes; M Lightfoote; P Piot; A R Ronald; J O Ndinya-Achola; L J D'Costa; P Roberts Journal: N Engl J Med Date: 1986-02-13 Impact factor: 91.245
Authors: J K Kreiss; R Coombs; F Plummer; K K Holmes; B Nikora; W Cameron; E Ngugi; J O Ndinya Achola; L Corey Journal: J Infect Dis Date: 1989-09 Impact factor: 5.226
Authors: R M Greenblatt; S A Lukehart; F A Plummer; T C Quinn; C W Critchlow; R L Ashley; L J D'Costa; J O Ndinya-Achola; L Corey; A R Ronald Journal: AIDS Date: 1988-02 Impact factor: 4.177
Authors: Carol Golin; Gary Marks; Julie Wright; Mary Gerkovich; Hsiao-Chuan Tien; Shilpa N Patel; Lytt Gardner; Christine O'Daniels; Tracey E Wilson; Mark Thrun; Melanie Thompson; Stephen Raffanti; E Byrd Quinlivan Journal: AIDS Behav Date: 2009-12