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Risk factors for HIV-1 seroconversion among young men in northern Thailand
D D Celentano1, K E Nelson, S Suprasert
1Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md 21205, USA.
JAMA
|January 10, 1996
Summary
This study found that sexual contact with female commercial sex workers and men, along with sexually transmitted diseases, significantly increased the risk of HIV-1 infection in young men in Thailand. Increased condom use is essential for prevention.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Human Immunodeficiency Virus-1 (HIV-1) infection remains a significant public health concern, particularly among young adult populations.
- Identifying specific behavioral and sociodemographic risk factors is crucial for developing targeted prevention strategies in high-incidence regions.
Purpose of the Study:
- To investigate behavioral and sociodemographic risk factors associated with new HIV-1 infections in healthy young men.
- To determine the incidence rate of HIV-1 infection within a cohort of military conscripts in northern Thailand.
Main Methods:
- A prospective cohort study followed 1932 HIV-1 seronegative military conscripts (aged 19-23) in northern Thailand for two years.
- Risk factors were identified through interviews conducted at 6-month intervals.
- HIV-1 seroincidence was determined using enzyme-linked immunosorbent assay and Western blot, with univariate and multivariate analyses performed.
Main Results:
- An HIV-1 incidence rate of 2.43 per 100 person-years was observed, with 85 men seroconverting.
- Key predictors of HIV-1 seroconversion included frequent visits to female commercial sex workers (CSWs), sex with men, and incident sexually transmitted diseases (STDs).
- While univariate analysis suggested a protective effect of frequent condom use with CSWs, multivariate analysis did not confirm this, indicating complex interactions.
Conclusions:
- HIV-1 incidence in this cohort is largely driven by sexual contact with female CSWs and, to a lesser extent, sex with men and STDs.
- Effective condom use programs, especially in brothels and with non-CSW partners, are critical for reducing HIV-1 transmission.
- Enhanced prevention and treatment of STDs are also necessary to curb HIV-1 infection rates in this population.