Document 0923
 DOCN  M94A0923
 TI    Risk factors for HIV seroconversion in commercial sex workers in
       Mombasa, Kenya: role of hormonal contraception & STDs.
 DT    9412
 AU    Martin HL Jr; Nyange PM; Jackson DJ; Mandaliya K; Holmes KK; Ngugi E;
       Ndinya-Achola JO; Plummer F; Kreiss J; University of Washington, Seattle
       98195.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):25 (abstract no. 394C). Unique
       Identifier : AIDSLINE ICA10/94371652
 AB    OBJECTIVES: To define the incidence and risk factors for HIV infection
       in a high risk population of commercial sex workers (CSW's) and to
       establish a cohort for future prophylactic HIV vaccine trials. METHODS:
       Prospective cohort study in women registered as CSW's in a municipal
       clinic. RESULTS: Between February 1993 and February 1994, 1585 women
       were counselled and screened for HIV. Seroprevalence of HIV was 56.5%,
       and 435 seronegative women were enrolled. Mean age was 28 years; mean
       duration of prostitution was 6 years. Mean sexual frequency was 1.6/week
       with 1 partner/week. Mean condom use was 63%, and the average charge for
       sex was KSh 638/= (US$9.5). Incidence of STD's was: gonorrhea 121/100
       p-y, trichomonas 56/100 p-y, genital ulcers 20/100 p-y, chlamydia 16/100
       p-y. Twenty-seven subjects seroconverted for HIV, an incidence rate of
       16.2/100 p-y. Compared to women remaining uninfected with HIV,
       seroconverters had fewer sexual partners/week (0.6 vs 1.0, p = .02) and
       lower sexual frequency/week (1.0 vs 1.6, p = .01). There was no
       difference in age, mean charge for sex, years of education, or reported
       condom use. HIV acquisition was associated with the use of oral
       contraceptives (OR 2.6, 1.0-6.8) and depo provera (OR 3.7, 1.4-9.6),
       presence of genital ulcers (OR 3.7, 1.4-9.9), gonorrhea (OR 2.2, CI
       1.2-3.7), and vaginal discharge (OR 2.0, 1.2-3.4). Trends towards
       positive associations with HIV seroconversion were found with vulvitis
       (OR 1.9, 0.8-5.0) and cervicitis (OR 1.5, 0.9-2.4). CONCLUSION: In this
       prospective study, HIV seroconversion was significantly associated with
       the use of oral contraceptives and depo provera, genital ulcers,
       gonorrhea, and vaginal discharge.
 DE    Cohort Studies  Comorbidity  *Contraceptives, Oral, Hormonal  Disease
       Susceptibility  Drug Utilization  Female  Gonorrhea/EPIDEMIOLOGY  Human
       HIV Seropositivity/*EPIDEMIOLOGY  Kenya/EPIDEMIOLOGY
       Leukorrhea/EPIDEMIOLOGY  *Medroxyprogesterone 17-Acetate  Occupational
       Diseases/*EPIDEMIOLOGY  Odds Ratio  Prospective Studies
       Prostitution/*STATISTICS & NUMER DATA  Risk Factors  Sexually
       Transmitted Diseases/*EPIDEMIOLOGY  Ulcer/EPIDEMIOLOGY  Urban Population
       MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).