       Document 0391
 DOCN  M9640391
 TI    Risk factors for HIV-1 seroconversion among young men in northern
       Thailand.
 DT    9604
 AU    Celentano DD; Nelson KE; Suprasert S; Eiumtrakul S; Tulvatana S;
       Kuntolbutra S; Akarasewi P; Matanasarawoot A; Wright NH; Sirisopana N;
       Theetranont C; Department of Health Policy and Management, Johns
       Hopkins; University School of Hygiene and Public Health, Baltimore, Md;
       21205, USA.
 SO    JAMA. 1996 Jan 10;275(2):122-7. Unique Identifier : AIDSLINE
       MED/96134954
 AB    OBJECTIVE--To identify behavioral and sociodemographic risk factors for
       incident human immunodeficiency virus-1 (HIV-1) infection among healthy
       young men in northern Thailand. DESIGN--Men inducted into military
       service in northern Thailand in May and November 1991 were followed at
       6-month intervals until discharge 2 years later. Trained nonmilitary
       interviewers identified risk factors for HIV-1 infection through
       interviews with the men. SETTING--Thirteen military bases in northern
       Thailand. PARTICIPANTS--A total of 1932 seronegative men, aged 19 to 23
       years (average age, 21 years) at enrollment, conscripted into the Royal
       Thai Army and Air Force from six upper-northern Thai provinces. MAIN
       OUTCOME MEASURES--Human immunodeficiency virus-1 seroincidence as
       determined through enzyme-linked immunosorbent assay and verified by
       Western blot, and univariate and multivariate analyses of risk factors
       related to HIV-1 incidence. RESULTS--A total of 85 men seroconverted to
       HIV-1 over the period of observation, giving an incidence rate of 2.43
       per 100 person-years. Factors strongly associated with HIV-1
       seroconversion were frequency of visits to female commercial sex workers
       (CSWs), sex with men, and incident sexually transmitted diseases (STDs).
       High frequency of condom use showed a significant (P < .001) protective
       effect for HIV-1 incidence among men with a history of recent sex with
       female CSWs in univariate analysis, but a multivariate model
       demonstrated no difference in HIV-1 seroconversion rates by consistency
       of condom use. Multivariate analysis incorporating condom use showed
       that having sex with men (adjusted relative risk [RR], 2.59; 95%
       confidence interval [CI], 1.08 to 6.25), having sex with CSWs (adjusted
       RR ranged from 2.54 [95% CI, 1.81 to 3.58] to 2.74 [95% CI, 1.56 to
       4.81]), and incident STDs (adjusted RR, 2.38 [95%, CI, 1.31 to 4.32]) to
       be predictors of incident HIV-1 infection. Substance use was not
       associated with HIV-1 seroconversion rates in multivariate analysis.
       CONCLUSION--The HIV-1 incidence in this cohort of young men appears to
       be primarily attributable to having sex with female CSWs. Condom use
       provided some protection, although not in multivariate analysis;
       however, condom use has previously been shown likely to be useful in
       preventing HIV-1 transmission. Thus, programs to increase effective
       condom use in brothels are essential. Efforts to extend condom use to
       non-CSW partners are especially needed. More effective prevention and
       treatment of STDs may also be necessary to decrease HIV-1 infection in
       this population.
 DE    Adult  AIDS Serodiagnosis  Human  HIV
       Seropositivity/*EPIDEMIOLOGY/TRANSMISSION  *HIV-1  Incidence  Male
       Military Personnel/STATISTICS & NUMER DATA  Multivariate Analysis
       Prospective Studies  Prostitution  Risk Factors  Risk-Taking  Sex
       Behavior  Sexually Transmitted Diseases, Viral/EPIDEMIOLOGY
       Socioeconomic Factors  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       Non-P.H.S.  Thailand/EPIDEMIOLOGY  JOURNAL ARTICLE

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

