       Document 0022
 DOCN  M95B0022
 TI    A community-wide outbreak of hepatitis A: risk factors for infection
       among homosexual and bisexual men.
 DT    9511
 AU    Henning KJ; Bell E; Braun J; Barker ND; Epidemiology Program Office, US
       Centers for Disease Control and; Prevention, Atlanta, Georgia, USA.
 SO    Am J Med. 1995 Aug;99(2):132-6. Unique Identifier : AIDSLINE
       MED/95351342
 AB    PURPOSE: To assess risk factors for hepatitis A infection among
       homosexual and bisexual men during a community-wide outbreak of
       hepatitis A in New York City. PATIENTS AND METHODS: Twenty-five
       homosexual and bisexual men, 20 to 49 years of age with hepatitis A
       identified from health department surveillance data (cases) were
       compared with 42 homosexual and bisexual men of similar age distribution
       who were seronegative for hepatitis A virus and identified from private
       physician offices (controls). Odds ratio (OR) were determined for acute
       hepatitis A infection according to demographics, numbers of sexual
       partners, frequency of specific sexual behaviors, and self-reported
       human immunodeficiency virus status. RESULTS: Cases had more anonymous
       sex partners (0 to 1 partner versus > 1 partner) than controls during
       the 6 weeks before illness onset (OR = 4.4, 95% confidence interval [CI]
       1.4 to 14.4). Cases were more likely than controls to have engaged in
       group sex (OR = 3.8, 95% CI 1.1 to 12.6). Among specific sexual
       behaviors examined, oral-anal intercourse (oral role) and digital-rectal
       intercourse (digital role) with anonymous sex partners were more
       commonly reported by cases than controls (OR = 9.7, 95% CI 1.2 to 78.7
       and OR = 2.6, 95% CI 1.0 to 7.4, respectively). Multivariate analysis
       showed that > 1 anonymous sex partner, group sex, oral-anal intercourse,
       and digital-rectal intercourse were associated with illness in models
       controlling for duration of sexual activity. Because these variables
       were highly correlated, independent risk could not be evaluated in a
       single model. CONCLUSIONS: Hepatitis A infection among homosexual and
       bisexual men is associated with oral-anal and digital-rectal
       intercourse, as well as with increasing numbers of anonymous sex
       partners and group sex. These findings reinforce the importance of
       developing educational activities for homosexual and bisexual men that
       focus on risk reduction for hepatitis A as well as other sexually
       transmitted disease spread via the fecal-oral route.
 DE    Adult  *Bisexuality/STATISTICS & NUMER DATA  Case-Control Studies
       Disease Outbreaks/*STATISTICS & NUMER DATA  Hepatitis
       A/*EPIDEMIOLOGY/ETIOLOGY  *Homosexuality, Male/STATISTICS & NUMER DATA
       Human  Male  Middle Age  Multivariate Analysis  New York
       City/EPIDEMIOLOGY  Questionnaires  Risk Factors  *Sex
       Behavior/STATISTICS & NUMER DATA  JOURNAL ARTICLE

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

