Risk factors for genital ulcerations in Kenyan sex workers. The role of human immunodeficiency virus type 1 infection.
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Date
1997Author
Kaul R.
Kimani J
Nagelkerke NJ.
Plummer, FA
Bwayo, JJ
Brunham RC.
Ngugi, Elizabeth N
Ronald, A
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
BACKGROUND AND OBJECTIVES: Genital ulcer disease (GUD) is a major risk factor for human immunodeficiency virus (HIV) transmission. Cross-sectional studies have suggested that HIV infection may itself predispose to genital ulceration (GU). GOAL: To prospectively study the effects of HIV type 1 (HIV-1) infection and behavioral variables on GU incidence. METHODS: A cohort of 302 Kenyan female sex-workers was established in April 1991. Women were scheduled for assessment every 2 weeks, and bloods were collected every 6 months for HIV serology, rapid plasma reagin (RPR) and CD4 counts. Logistic regression was used to study risk factors for incident genital ulcers. RESULTS: 189 women (62.5%) had at least one incident ulcer over 24.3 +/- 15.3 months. GU incidence was higher in seropositive than initially seronegative women (82% vs. 48%; odds ratio [OR]) = 4.33; P < 0.01). Only HIV-1 seropositivity (OR = 3.42), a CD4 count < 200/ml (OR = 1.94), and oral contraceptive use (OR = 1.35) were associated (P < 0.05) with GU incidence in regression analysis. For those ulcers where an etiology was actively sought, Hemophilus ducreyi was confirmed in 54 (19%) of cases, and syphilis in 30 (29%). CONCLUSION: GU incidence in Kenyan sex workers is independently affected by HIV-1 serostatus, degree of immunosuppression, and oral contraceptive use.
URI
http://www.ncbi.nlm.nih.gov/pubmed/9263358http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/16229
Citation
Sex Transm Dis. 1997 Aug;24(7):387-92Publisher
Department of Medical Microbiology, University of Nairobi, Kenya Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada Department of Community Health, University of Nairobi, Departmrnt of infectious Disease, University of Toronto, Canada
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- Faculty of Health Sciences (FHS) [10378]