Document 0240
 DOCN  M95A0240
 TI    HIV-1 prevalence and risk factors among sexually transmitted disease
       clinic attenders in Trinidad.
 DT    9510
 AU    Cleghorn FR; Jack N; Murphy JR; Edwards J; Mahabir B; Paul R; White F;
       Bartholomew C; Blattner WA; Viral Epidemiology Branch, National Cancer
       Institute, National; Institutes of Health, Bethesda, Maryland, USA.
 SO    AIDS. 1995 Apr;9(4):389-94. Unique Identifier : AIDSLINE MED/95314795
 AB    OBJECTIVES: To study trends in prevalence and to ascertain risk factors
       for HIV-1 among sexually transmitted disease (STD) clinic attenders in
       Trinidad. DESIGN AND METHODS: Serial cross-sectional studies were
       conducted in 1987-1988 and 1990-1991 at a centralized STD clinic in Port
       of Spain. A case-control study was carried out to examine in greater
       detail the demographic and behavioral risk factors for HIV-1 among
       self-declared heterosexuals in this population. RESULTS: HIV-1
       prevalence increased from 3.0% [95% confidence interval (CI), 2.3-3.9]
       in 1987-1988 to 13.6% (95% CI, 11.8-15.6) in 1990-1991. Age > or = 40
       years [odds ratio (OR), 2.0; 95% CI, 1.4-2.8], urban residence (OR, 2.2;
       95% CI, 1.6-3.0), and human T-lymphotropic virus-I seropositivity (OR,
       3.1; 95% CI, 1.6-6.0) were significant risk factors for HIV-1 in
       1990-1991. In the case-control analysis, significant independent risk
       factors for men included current genital ulcer disease (OR, 5.2; 95% CI,
       2.2-12.5), current genital warts (OR, 3.9; 95% CI, 1.2-12.0), having
       ever had syphilis (OR, 3.2; 95% CI 1.6-6.1), and use of crack cocaine in
       the preceding 6 months (OR, 6.2; 95% CI, 2.7-14.2). Corresponding risk
       factors for women were commercial sex work (OR, 5.7; 95% CI, 1.3-25.7),
       initiation of sexual activity before age 14 years (OR, 4.8; 95% CI,
       1.5-16.0), and past non-gonococcal cervicitis (OR, 4.1; 95% CI,
       1.3-13.1). CONCLUSIONS: HIV-1 in this setting is primarily
       heterosexually transmitted in a milieu of unprotected sexual activity
       fuelled by a crack cocaine epidemic. Targeted interventions to prevent,
       detect and treat STD and crack cocaine addiction, as well as disrupt
       their adverse synergism, may substantially reduce HIV-1 transmission in
       this population.
 DE    Adult  Ambulatory Care Facilities  Case-Control Studies  Crack Cocaine
       Cross-Sectional Studies  Female  Human  HIV
       Infections/COMPLICATIONS/*EPIDEMIOLOGY/TRANSMISSION  HIV
       Seroprevalence/TRENDS  *HIV-1  Male  Risk Factors  Seroepidemiologic
       Methods  Sex Behavior  Sexually Transmitted Diseases/COMPLICATIONS
       Support, U.S. Gov't, P.H.S.  Trinidad and Tobago/EPIDEMIOLOGY  JOURNAL
       ARTICLE

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