Chancroid epidemiology in New Orleans men

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Nonsyphilitic genital ulcer disease (GUD) presents diagnostic challenges.
• Distinguishing between chancroid and other GUDs is crucial for effective treatment and public health interventions.

Purpose of the Study:

• To investigate the epidemiologic, clinical, and microbiologic characteristics of GUD in men.
• To identify risk factors associated with chancroid and culture-negative GUD.
• To establish potential links between specific behaviors and GUD etiology.

Main Methods:

• Collection of epidemiologic, clinical, and microbiologic data from 299 men with GUD.
• Cultures for Haemophilus ducreyi and herpes simplex virus.
• Statistical analysis to compare risk factors between patient groups.

Main Results:

• Haemophilus ducreyi (chancroid) was identified in 39% of cases, herpes simplex virus in 19%, and 41% were culture-negative.
• Chancroid patients were significantly more likely to report frequent alcohol use, recent cocaine use, sex with a prostitute, trading drugs for sex, and having a sex partner who used drugs.
• Culture-negative GUD patients shared epidemiologic similarities with chancroid patients but had clinical features resembling genital herpes.

Conclusions:

• A significant link exists between chancroid in the United States and the use of crack cocaine.
• Epidemiologic risk factors, particularly substance use and associated sexual behaviors, play a critical role in GUD transmission.
• Further research is needed to understand the etiology of culture-negative GUD.