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Risk factors for HTLV-I among heterosexual STD clinic attenders
J P Figueroa1, J Morris, A Brathwaite
1Ministry of Health, Kingston, Jamaica.
Insights
Human T-cell lymphotropic virus type 1 (HTLV-I) infection was studied in Jamaican STD clinic patients. Risk factors included blood transfusion history, marital status, occupation, sexual behaviors, and co-infections like hepatitis B and HIV.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Human T-cell lymphotropic virus type 1 (HTLV-I) is a retrovirus associated with serious illnesses.
- Understanding HTLV-I prevalence and transmission in sexually transmitted disease (STD) clinics is crucial for public health interventions.
Purpose of the Study:
- To determine the seroprevalence of HTLV-I among patients attending an STD clinic in Kingston, Jamaica.
- To identify risk factors associated with HTLV-I infection in this population.
Main Methods:
- Cross-sectional study of 994 patients presenting with new STD complaints between November 1990 and January 1991.
- HTLV-I serostatus was assessed using serological tests.
- Logistic regression analysis was employed to identify independent risk factors.
Main Results:
- HTLV-I seroprevalence was 7.0% in heterosexual men and 7.9% in women.
- Blood transfusion history was significantly associated with HTLV-I in men.
- Independent risk factors in men included marital status, agricultural occupation, bruising during sex, early age at first intercourse, and hepatitis B surface antigen positivity.
- In women, risk factors included multiple sex partners, early age at first intercourse, bruising during sex, syphilis seroreactivity, and HIV infection.
Conclusions:
- HTLV-I infection is prevalent in Jamaican STD clinic attendees.
- Specific demographic, occupational, and behavioral factors are associated with HTLV-I infection, highlighting potential transmission routes.
- Findings underscore the need for targeted prevention and screening strategies within STD clinics.
Abstract:
Human T-cell lymphotropic virus type 1 (HTLV-I) status was assessed in 994 patients attending a sexually transmitted disease (STD) clinic in Kingston, Jamaica, between November 1990 and January 1991 for a new STD complaint. Of 515 heterosexual men, 36 (7.0%) were HTLV-I seropositive, as were 38 (7.9%) of 479 women. HTLV-I seroprevalence increased with age in women. A history of blood transfusion was associated with HTLV-I in both sexes, significantly so in men [odds ratio (OR) 4.7, confidence interval (CI) 1.1-17 for men; OR 1.9, CI 0.6-5.0 for women]. Further analysis excluded all persons reporting a transfusion. On multiple logistic regression analysis, independent associations with HTLV-I infection in men were shown for marital status (OR 3.5, CI 1.2-10 for married/common law vs. single/visiting unions), agricultural occupation (OR 9.0, CI 2.0-41), bruising during sex (OR 2.9, CI 1.0-8.1), > or = 15 years at first sexual intercourse (OR 2.9, CI 1.0-8.2), and a positive test for hepatitis B surface antigen (OR 7.3, CI 1.2-52). In women, associations were shown for two or more sex partners in the 4 weeks prior to complaint (OR 4.9, CI 1.8-13), 11 or more lifetime sexual partners (OR 5.9, CI 1.3-27), aged < 15 years at first sexual intercourse (OR 2.3, 1.0-5.4), bruising during sex (OR 2.7, CI 1.1-6.6), microhaemagglutination-Treponema pallidum positivity (OR 3.6, CI 1.6-8.4), and human immunodeficiency virus infection (OR 14, CI 2.1-92).(ABSTRACT TRUNCATED AT 250 WORDS)