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Cited by 98HIV/AIDS Research and InterventionsReproductive tract infections researchHIV, Drug Use, Sexual Risk

Rectal gonorrhoea as an independent risk factor for HIV infection in a cohort of homosexual men.

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Craib, K J, Meddings, D R, Strathdee, S A, Hogg, R S, Montaner, J S, O'Shaughnessy, M V, Schechter, M T·1995·Sexually Transmitted Infections
DOI 10.1136/sti.71.3.150PMC PMC1195487
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Abstract

OBJECTIVE: To determine whether certain sexually transmitted diseases are independent risk factors for HIV transmission in a cohort of homosexual men. METHODS: Eligible cases were identified as those who had seroconverted between November 1982 and November 1990. Two persistently HIV-seronegative control participants were randomly selected for each case from all participants who remained seronegative in November 1990. For cases, risk factor data were taken from an index visit which was defined as the first seropositive visit, while for controls these data were obtained from a matched visit which occurred within two months of the index visit for the corresponding case. Mantel-Haenszel methods and logistic regression were used to compare differences in risk factors for seroconversion between cases and controls. RESULTS: A total of 125 cases and 250 controls were eligible for this study. Cases were significantly more likely to have had reported any gonorrhoea (17% versus 6%; OR = 2.94; 95% CI: 1.51-5.73) or syphilis (7% versus 2%; OR = 3.78; 95% CI: 1.33-10.79) than controls during the seroconversion period. Multivariate logistic regression revealed rectal gonorrhoea to be independently associated with risk of seroconversion (odds ratio = 3.18; p = 0.044), whereas urethral gonorrhoea (p = 0.479) and pharyngeal gonorrhoea (p = 0.434) were not after inclusion of rectal gonorrhoea. In addition, the following variables were also shown to exert an independent effect on seroconversion: frequency of anal intercourse, use of illicit drugs, number of male sexual partners, and lack of a post-secondary education. CONCLUSIONS: In this observational study, rectal gonorrhoea was found to be associated with HIV seroconversion after adjustment for a number of HIV risk factors. We cannot rule out that rectal gonorrhoea was not directly associated with HIV infection but rather with other residual lifestyle factors not fully adjusted for in the analysis. However, the relationship with gonococcal involvement of a specific anatomic site lends support to a biological association between gonorrhoea and HIV infection, rather than to alternative non-biologic explanations. Our findings are consistent with previous studies reporting an association between HIV infection and non-ulcerative sexually transmitted diseases. Such a direct association might be explained by postulating that gonorrhoea results in inflamed rectal mucosa and compromised epithelial integrity, thereby predisposing an individual to subsequent HIV infection.

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Research works printed but not linked: 29

  1. Nsubuga P, Mugerwa R, Nsibambi J, et al. The association of genital ulcer disease and HIV infection at a dermatol- ogy-STD clinic in Uganda. JAIDS 1990;3:1002-5.
  2. Latif AS, Katzenstein DA, Bassett MT, et al. Genital ulcers and transmission of HIV among couples in Zimbabwe. AIDS 1989;3:519-23.
  3. Plummer FA, Simonsen JN, Cameron DW, et al. Cofactors in male-female sexual transmission of human immunodeficiency virus type 1. J Infect Dis 1991;163: 233-9.
  4. Simonsen JN, Cameron DW, Gakinya MN, et al. Human immunodeficiency virus infection among men with sexu- ally transmitted diseases. N EnglJ Med 1988;319:274-8.
  5. Kreiss JK, Coombs R, Plummer F, et al. Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes. T Infect Dis 1989;160:380-4.
  6. Stamm WE, Handfield HH, Rompalo AM, Ashley RL, Roberts PL, Corey L. The association between genital ulcer disease and acquisition of HIV infection in homo- sexual men. JAAA 1988;260:1429-33.
  7. Hoimberg SD, Stewart JA, Gerber AR, et al. Prior herpes simplex virus type 2 infection as a risk factor for HIV infection. JAMA 1988;259:1048-50.
  8. Aral SO, Holmes KK. Epidemiology of sexual behavior and sexually transmitted diseases. In: Hoimes KK, Mardh PA, Sparling PF, Wiesner PJ, eds. Sexually Transmitted Diseases, 2nd ed New York: McGraw-Hill Information Services Company, 1990:19-36.
  9. Laga M, Abib M, Mayimona K, et al. Non-ulcerative sexu- ally transmitted diseases as risk factors for HIV-1 trans- mission in women: results from a cohort study. AIDS 1993;7:95-102.
  10. Haley CE, Anderson P, Freeman A, Petty A. Relationship of STD history to HIV seropositivity in a cohort of homosexual men in Dallas, Texas. Int Conf AIDS 1989 June 4-9;5: 126 (abstract no.
  11. Schechter MT, Boyko WJ, Douglas B, et al. The Vancouver Lymphadenopathy-AIDS Study, 6: HIV seroconversion in a cohort of homosexual men. Can Med AssocJ 1986;135:1355-60.
  12. Schechter MT, Craib KJP, Le TN, Willoughby B, et al. Progression to AIDS and predictors of AIDS in sero- prevalent and seroincident cohorts of homosexual men. AIDS 1989;3:347-53.
  13. Miettinen 0. Estimability and estimation in case-referent studies. Am J Epidemiol 1976;103:226-35.
  14. Darrow WW, Echenberg DF, Jaffe HW, et al. Risk factors for human immunodeficiency virus (HIV) infections in homosexual men. Am J Publ Health 1987;77:479-83.
  15. Kingsley LA, Detre K, Kelsey S, et al. Risk factors for sero- conversion to human immunodeficiency virus among male homosexuals. Lancet 1987;1:345-9.
  16. Winkelstein W Jr, Lyman DM, Padian N, et al. Sexual practices and risk of infection by the human immunode- ficiency virus. The San Francisco Men's Health Study. JAMA 1987;257:321-5.
  17. Stall R, McKusick L, Wiley J, Coates TJ, Ostrow DG. Alcohol and drug use during sexual activity and compli- ance with safe sex guidelines for AIDS: The AIDS Behavioral Research Project. Health Educ Q 1986;13: 359-71.
  18. Ostrow DG, VanRanden MJ, Fox R, et al. Recreational drug use and sexual behavior change in a cohort of homosexual men. AIDS 1990;4:759-65.
  19. Hogg RS, Craib K, Willoughby B, Sestak P, Montaner JSG, Schechter MT. Sociodemographic correlates for risk taking behavior among seronegative men. Canadian Journal ofPublic Health 1993;84:423-6.
  20. Hogg RS, Strathdee SA, Craib KJP, O'Shaughnessy MV, Montaner JSG, Schechter MT. Lower socioeconomic status and shorter survival following HIV infection. Lancet 1994;344:1120-4.
  21. Mertens TE, Hayes RJ, Smith PJ. Epidemiological meth- ods to study the interaction between HIV infection and other sexually transmitted diseases. AIDS 1990;4:57-65.
  22. Saltzman SP, Stoddard AM, McCusker J, et al. Reliability of self-reported behavior risk factors for HIV infection in homosexual men. Public Health Rep 1987;102:692-7.
  23. Spanier GB. Use of recall data in survey research on human sexual behavior. Soc Biol 1976;23:244-53.
  24. Coates RA, Soskolne CL, Calzavara L, et al. The reliability of sexual histories in AIDS-related research: Evaluation of an interview-administered questionnaire. Can J3 Pub Health 1986;77:343-8.
  25. Van de Perre P, De Clerq A, Cognaiux-Leclerc J, Nzaramba D, Butzler J-P, Sprecher-Goldberger S. Detection of HIV p17 antigen in lymphocytes but not epithelial cells from cervicovaginal secretions of women seropositive for HIV: implications for heterosexual trans- mission of the virus. Genitourin Med 1988;64:30-3.
  26. Wolff H, Anderson DJ. Male genital tract inflammation associated with increased numbers of potential human immunodeficiency virus host cells in semen. Andrologia 1988;20:404-10.
  27. Alexander N. Sexual transmission of human immunodefi- ciency virus: virus entry into male and female genital tract. Fertil Steril 1990;54:1-18.
  28. Kreiss J, Carael M, Meheus A. Role of sexually transmit- ted diseases in transmitting human immunodeficiency virus. Genitourin Med 1988;64: 1-2.
  29. Moss GB, Hensel M, Emerman M, et al. Prevalence and correlates of HIV in urethral secretions of men with purulent urethritis. Int Conf AIDS 1992 July 19-24; 8(2):C327 (abstract no. PoC 4497). 154 on July 19, 2023 by guest. Protected by copyright. http://sti.bmj.com/ Genitourin Med: first published as 10.1136/sti.71.3.150 on 1 June 1995. Downloaded from

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Authors
Craib, K. J., Meddings, D. R., Strathdee, S. A., Hogg, R. S., Montaner, J. S., O'Shaughnessy, M. V., & Schechter, M. T.
Affiliations
St. Paul's Hospital (CA)
ORCID
Venue
Sexually Transmitted Infections
Publisher
BMJ
Published
1995-06-01
Volume
71
Issue
3
Pages
150-154
ISSN
  • 0007-134X (ISSN-L)
  • 1368-4973
DOI
10.1136/sti.71.3.150
PMC
PMC1195487
OpenAlex
W2079981443
Cited by
98
References
0
Citations by year
2025: 1 · 2024: 1 · 2023: 3 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 7 · 2016: 8 · 2015: 5 · 2014: 7 · 2013: 4 · 2012: 2
FWCI
2.81
Type
journal article
Language
en
Open access
Locations
  • Sexually Transmitted Infections (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
rectal gonorrhea, HIV seroconversion, HIV transmission risk factors, gay men, sexually transmitted infections, syphilis, pharyngeal gonorrhea, anal sex, illicit drug use, number of sexual partners, HIV risk behavior, HIV prevention strategies, men who have sex with men
MeSH terms
Adult, Gonorrhea, HIV Seropositivity, Humans, Male, Rectal Diseases, Risk Factors, Syphilis, Cohort Studies, HIV Infections, Logistic Models, Case-Control Studies, Homosexuality, Male

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