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Francis A. Plummer, J. Neil Simonsen, D. William Cameron, Jackoniah O. Ndinya-Achola, Joan K. Kreiss, Michael N. Gakinya, Peter Waiyaki, Mary Cheang, Peter Piot, Allan R. Ronald, Elizabeth N. Ngugi, Cofactors in Male-Female Sexual Transmission of Human Immunodeficiency Virus Type 1, The Journal of Infectious Diseases, Volume 163, Issue 2, February 1991, Pages 233–239, https://doi.org/10.1093/infdis/163.2.233
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Abstract
In a study of human immunodeficiency virus type 1 (HIV-1)-uninfected African prostitutes, 83 (67%) of 124 sero converted to HIV-1. Oral contraceptive use (odds ratio [OR], 3.1; 95% confidence interval (CI], 1.1–8.6;P < .03), genital ulcers (mean annual episodes, 1.32 ± 0.55 in seroconverting women vs. 0.48 ± 0.21 in seronegative women; P < .02) and Chlamydia trachomatis infections (OR, 3.6;CI, 1.3–11.0; P < .02)were associated with increased risk of HIV-1 infection. Condom use reduced the risk of HIV-1 infection (OR, 0.11; CI, 0.05–0.27; P < .0001). Stepwise logistic regression analysis confirmed independent associations between HIV-l infection and oral contraceptive use, condom use, genital ulcers, and C. trachomatis. The presence of other sexually transmitted diseases may in part explain the heterosexual HIV-1 epidemic in Africa and may represent important targets for intervention to control HIV-1 infection.