Cofactors in male-female sexual transmission of human immunodeficiency virus type 1

Article Abstract:

Human immunodeficiency virus (HIV) causes AIDS. HIV infection attacks the immune system and places infected individuals at risk for developing opportunistic infections, which can be life-threatening. HIV infection first appeared as a disease that was transmitted by anal intercourse among homosexual men and by intravenous drug use. However, it is becoming apparent that HIV infection can be transmitted between heterosexual partners. In the United States, heterosexually-transmitted HIV is not very common, and only accounts for 4 percent of all AIDS cases. Infection of regularly exposed female partners of men with HIV type 1 (HIV-1) is thought to be infrequent. However, a recent study predicted that spouses of male AIDS patients have a 42 percent risk of contracting HIV-1 infection. Although HIV-1 is carried in the semen of infected men, all female sexual partners of men with HIV-1 do not become infected. In Africa, however, HIV-1 is a heterosexually transmitted disease. Those at greatest risk for contracting HIV-1 are prostitutes and their customers, and men and women who have several different sex partners. The reason why heterosexually-transmitted HIV-1 is much more prevalent in Africa than in the US is unknown. To identify the risk factors associated with and the rate of occurrence of heterosexually-transmitted HIV-1 infection in Africa, 595 prostitutes from Nairobi were assessed. When blood samples were tested for HIV-1 at the beginning of the study, it was found that 399 women were infected (seropositive) and 196 were not (seronegative). Within 6 months, 83 of the seronegative women became infected with HIV. Within 1 year, 72 more women became seropositive and only 41 women remained seronegative. Risk factors associated with developing HIV-1 infection included genital sores and infection with Chlamydia trachomatis. The use of condoms reduced the risk of getting HIV-1 infection. The reason for the heterosexual HIV-1 epidemic in Africa is unknown, but frequent heterosexual anal intercourse and the presence of other sexually transmitted diseases may be contributing factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Demographic aspects, Diseases, HIV (Viruses), HIV, Disease transmission, Africa, Heterosexuals

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Maternal gonococcal infection as a preventable risk factor for low birth weight

Article Abstract:

Premature delivery and low birth weight are a major contributor to poor infant outcome. It has been posited that infection in the mother may be a major cause of prematurity. In a large maternity hospital in Nairobi, there is a high incidence of sexually transmitted diseases among delivering mothers, which can be transferred to their infants. The association between sexually transmitted diseases and low-birth-weight delivery (less than 2,500 grams or 5.5 pounds) was studied in 166 women having preterm delivery (before 36 weeks of pregnancy) and 175 going to full term. The incidence of infection with syphilis, gonorrhea, chlamydia, haemophilus, streptococcus, enterobacteriaceae and human immunodeficiency virus was determined from blood and vaginal culture analysis. Women with a gonococcal infection were three times more likely to deliver preterm. Four percent of the term and 11 percent of the preterm infants were infected with gonorrhea. Although 30 percent of the women with premature delivery had premature rupture of the fetal membranes, the association between gonorrhea and preterm delivery was independent of the mother's age, rupture of the membranes surrounding the fetus and high blood pressure, which are other known risk factors. A similar association was not seen with the other sexually transmitted diseases. If this association is correct, maternal gonorrhea infection may have been responsible for 51 percent of the premature deliveries. If maternal gonorrhea is diagnosed and treated early, the prematurity rate could be reduced by 14 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Causes of, Birth weight, Low, Low birth weight, Communicable diseases, Pregnancy, Premature birth, Gonorrhea, Pregnancy, Complications of, Pregnancy complications, Communicable diseases in pregnancy

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Risk factors for genital ulcerations in Kenyan sex workers: the role of human immunodeficiency virus type 1 infection

Article Abstract:

Several factors appear to increase a woman's risk for developing genital ulcer disease (GUD). Blood samples were evaluated and physical examinations were performed routinely on 302 female Kenyan prostitutes. Eighty-two percent of the women initially HIV-positive and 48% of the women initially HIV-negative later developed GUD. Women with low CD4 counts were 1.94 times more likely to develop GUD. Women using oral contraceptives were 1.35 times more likely to develop GUD. Syphilis was the most common GUD identified.

Health aspects, Ulcers, Prostitutes, Oral contraceptives, Genital diseases, Female, Female genital diseases

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