       Document 0058
 DOCN  M9610058
 TI    A case-control study of human immunodeficiency virus type 1
       seroconversion and risk-related behaviors in the Chicago MACS/CCS
       Cohort, 1984-1992. Multicenter AIDS Cohort Study. Coping and Change
       Study.
 DT    9601
 AU    Ostrow DG; DiFranceisco WJ; Chmiel JS; Wagstaff DA; Wesch J; Department
       of Psychiatry and Behavioral Medicine, Medical College; of Wisconsin,
       Milwaukee 53202, USA.
 SO    Am J Epidemiol. 1995 Oct 15;142(8):875-83. Unique Identifier : AIDSLINE
       MED/96017411
 AB    This paper focuses on 76 human immunodeficiency virus type 1 (HIV-1)
       seroconverters who concurrently participated in the Chicago, Illinois,
       component of the Multicenter AIDS Cohort Study (MACS) and the Coping and
       Change Study (CCS) of homosexual/bisexual men between 1984 and 1992. A
       nested case-control analysis was performed to assess the critical
       behavioral risk factors associated with incident HIV-1 infection and the
       consistency of these relations in early (1984-1988) versus later
       (1989-1992) phases of the study. Univariate results revealed strong
       early period associations between seroconversion and various measures of
       receptive anal intercourse (RAI) that became considerably weaker in the
       study's later period. The weaker associations reflected the overall
       decline in levels of RAI among the cohort during the 9 years of
       observation. In contrast, univariate results revealed stronger later
       period associations between seroconversion and measures of receptive
       oral intercourse and insertive anal intercourse. Subsequent multivariate
       testing did not support the hypothesis that receptive oral intercourse
       and/or insertive anal intercourse have replaced unprotected RAI as
       important risk behaviours in the homosexual transmission of HIV-1. In
       conditional logistic regression models combining intercourse measures
       with indices of drug and condom use, only the latter variables were
       consistently associated with HIV-1 seroconversion in both early and
       later study periods. Adjusted odds ratios (ORs) for nonuse of condoms
       during RAI were consistently significant throughout the study (ORs =
       3.7-4.8), while adjusted odds ratios for recreational drug use variables
       rose dramatically during the latter half of the study (e.g., for use of
       cocaine, OR = 81.3 (95% confidence interval 0-824), and for use of
       nitrite poppers, OR = 9.1 (95% confidence interval 1.8-45.5)). The
       behavioral intervention applications of these findings, as well as their
       relation to data from other recent cohort studies of HIV-1
       seroconversion among homosexual/bisexual men, are discussed.
 DE    Analysis of Variance  *Bisexuality  Case-Control Studies
       Chicago/EPIDEMIOLOGY  Cohort Studies  Health Behavior  *Homosexuality,
       Male  Human  HIV Seropositivity/BLOOD/PSYCHOLOGY/*TRANSMISSION
       *HIV-1/IMMUNOLOGY  Logistic Models  Male  Risk Factors  Support, U.S.
       Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

