Abstract:
OBJECTIVE:To investigate the risk factors for HIV infection in patients attending clinics for sexually transmitted diseases in India. DESIGN:Descriptive study of HIV serology, risk behaviour, and findings on physical examination. SUBJECTS:2800 patients presenting to outpatient clinics between 13 May 1993 and 15 July 1994. SETTING:Two clinics and the National AIDS Research Institute, in Pune, Maharashtra State, India. MAIN OUTCOME MEASURE:HIV status, presence of sexually transmitted diseases, and sexual behaviour. RESULTS:The overall proportion of patients infected with HIV was 23.4% (655/2800); 34% (184) of the women and 21% (459) of the men were positive for HIV infection. Of the 560 women screened, 338 (60%) had a reported history of sex working, of whom 153 (45%) were infected with HIV-1. The prevalence of HIV-1 infection in the 222 women who were not sex workers was 14%. The significant independent characteristics associated with HIV infection based on a logistic regression analysis included being a female sex worker, sexual contact with a sex worker, lack of formal education, receptive anal sex in the previous three months, lack of condom use in the previous three months, current or previous genital ulcer or genital discharge, and a positive result of a Venereal Disease Research Laboratory test. CONCLUSIONS:In India the prevalence of HIV infection is alarmingly high among female sex workers and men attending clinics for sexually transmitted diseases, particularly in those who had recently had contact with sex workers. A high prevalence of HIV infection was also found in monogamous, married women presenting to the clinics who denied any history of sex working. The HIV epidemic in India is primarily due to heterosexual transmission of HIV-1 and, as in other countries, HIV infection is associated with ulcerative and non-ulcerative sexually transmitted diseases. :During May 1994-July 1995 in India, health workers at two clinics for sexually transmitted diseases (STDs) in Pune provided HIV serological screening and a physical examination to 2800 patients who completed a questionnaire, so that researchers could identify risk factors for HIV-1 infection in this high-risk population. 60% of the female STD patients were sex workers. 90% of the men had contact with a sex worker within the last 3 months. 14% of all STD patients were women who were not sex workers. 82% of these were married and monogamous. 13% of the married and monogamous women tested positive for HIV-1. Overall, 23.4% of all STD patients tested positive for HIV-1. Only 24% of all STD patients had used condoms during the last 3 months. The leading clinical diagnosis was chancroid (33% for men and 20% for women). The logistic regression analysis showed that the risk factors for HIV-1 infection were: being a sex worker (odds ratio [OR] = 3.7; p 0.001), contact with a sex worker (OR = 1.71; p = 0.01), receptive anal sex (OR = 3.52; p 0.001), tattooed after 1985 (OR = 1.31; p = 0.01), current or previous genital ulcer (OR = 1.29; p = 0.01), and a positive result of a Venereal Disease Research Laboratory test (OR = 1.33; p = 0.01). Protective factors were some formal education (OR = 0.76; p = 0.02), and condom use (sometimes/always, OR = 0.75; p = 0.03). These findings indicate a need for comprehensive and national STD services in India to control STDs and a health education campaign on HIV/AIDS to reduce high risk behavior.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Rodrigues JJ,Mehendale SM,Shepherd ME,Divekar AD,Gangakhedkar RR,Quinn TC,Paranjape RS,Risbud AR,Brookmeyer RS,Gadkari DAdoi
10.1136/bmj.311.7000.283keywords:
["Asia","Behavior","Biology","Currently Married--women","Developing Countries","Diseases","Examinations And Diagnoses","Hiv Infections","Hiv Serodiagnosis","India","Infections","Laboratory Examinations And Diagnoses","Marital Status","Measurement","Nuptiality","Prevalence","Prostitutes","Reproductive Tract Infections","Research Methodology","Research Report","Risk Factors","Sex Behavior","Sexually Transmitted Diseases","Southern Asia","Viral Diseases"]subject
Has Abstract,Author List Incompletepub_date
1995-07-29 00:00:00pages
283-6issue
7000eissn
0959-8138issn
1756-1833journal_volume
311pub_type
杂志文章abstract:OBJECTIVES:To investigate the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer and to evaluate the potential dose-response relation. DESIGN:Meta-analysis and systematic review of prospective cohort studies. DATA SOURCES:PubMed and Embase up to December 20...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
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abstract::A study was carried out analysing the operation of a drug rationalisation programme in a central London teaching district that had evolved from experience over 17 years. Creation of a limited list of about 700 drugs had been achieved by local consensus. Drug selection was based on appraisal of efficacy, safety, and co...
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更新日期:1988-08-13 00:00:00
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更新日期:2008-11-07 00:00:00
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更新日期:2015-07-31 00:00:00
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更新日期:2005-09-10 00:00:00
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更新日期:2013-02-13 00:00:00
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更新日期:2012-11-27 00:00:00