       Document 0485
 DOCN  M9650485
 TI    High rates of sexual contact with female sex workers, sexually
       transmitted diseases, and condom neglect among HIV-infected and
       uninfected men with tuberculosis in Abidjan, Cote d'Ivoire.
 DT    9605
 AU    Sassan-Morokro M; Greenberg AE; Coulibaly IM; Coulibaly D; Sidibe K;
       Ackah A; Tossou O; Gnaore E; Wiktor SZ; De Cock KM; Project RETRO-CI,
       Abidjan, Cote d'Ivoire.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Feb 1;11(2):183-7.
       Unique Identifier : AIDSLINE MED/96147319
 AB    To characterize human immunodeficiency virus (HIV) risk practices among
       men with tuberculosis, and to determine what factors are associated with
       HIV infection in this population, we conducted a case-control analysis
       of data collected during enrollment in a prospective cohort study in the
       two large tuberculosis treatment centers of Abidjan, Cote d'Ivoire.
       Demographic information and data on risk factors for HIV infection,
       including history of sex with female sex workers (FSWs) and history of
       sexually transmitted diseases (STDs), were collected on 490 HIV-infected
       and 239 HIV-uninfected men diagnosed with pulmonary tuberculosis between
       1989 and 1992. HIV-infected men were significantly more likely than
       uninfected men to have had sex with FSWs in their lifetime [83 versus
       63%, odds ratio (OR) 2.9, 95% confidence internal (CI) 2.0-4.2], genital
       ulcer disease in the past 5 years (38 versus 15%, OR 3.4, 95% CI
       2.2-5.2), urethritis in the past 5 years (44 versus 23%, OR 2.6, 95% CI
       1.8-3.8), and sex with FSWs in the past year (43 versus 25%, OR 2.3, 95%
       CI 1.6-3.3); no difference was found in the proportion with at least one
       non-FSW partner in the past year (84 versus 79%, OR 1.3, 95% CI
       0.9-2.0). Among all men, 74% never used condoms, and only 1.4% always
       used condoms. In a multivariate analysis, sex with FSWs, genital ulcer
       disease, urethritis, and lack of circumcision were all significantly
       associated with HIV. This study demonstrates the critical roles of
       commercial sex, STDs, and condom neglect in fueling the HIV/AIDS
       epidemic in Abidjan, and illustrates the urgent need for widespread HIV
       education both in the general population and in men with tuberculosis.
 DE    Adolescence  Adult  Analysis of Variance  Case-Control Studies  Child
       Cohort Studies  Condoms/*UTILIZATION  Cote d'Ivoire/EPIDEMIOLOGY  Female
       Health Education  Human  HIV Antibodies/ANALYSIS  HIV
       Infections/COMPLICATIONS/*EPIDEMIOLOGY  *HIV-1/IMMUNOLOGY
       *HIV-2/IMMUNOLOGY  Male  Prospective Studies  *Prostitution  Risk
       Factors  *Sex Behavior  Sexual Partners  Sexually Transmitted
       Diseases/*EPIDEMIOLOGY  Tuberculosis,
       Pulmonary/COMPLICATIONS/*EPIDEMIOLOGY  JOURNAL ARTICLE

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

