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).