Shedding of HIV-1 subtype E in semen and cervico-vaginal fluid.

The uneven expansion of HIV-1 subtypes in each transmitted group raises the possibility that some viruses have less/more potential by qualitative/quantitative for heterosexual transmission compared to others. In Thailand, HIV-1 subtype E is mainly spread via heterosexual route and accounts for about 95 per cent of the infected cases. To determine whether high sexual infectivity of HIV-1 subtype E is due to the presence of a virus in genital fluid, we conducted a study to characterize shedding of HIV-1 in seminal and cervico-vaginal fluids of 30 HIV-1 subtype E infected Thai couples by PCR and virus isolation methods. All subjects had no HIV-associated diseases and other sexually transmitted diseases. HIV-1 subtype E DNA was detected in 22/30 (77.33%) of cervico-vaginal and also 22/30 (77.33%) of seminal fluid samples. The isolation rate of HIV-1 from semen and cervico-vaginal secretion was 36.67 per cent and 16.67 per cent, respectively. Number of HIV-1 subtype E DNA copies in the blood is reversely correlated with the number of blood CD4+ T cells, while that in genital fluid was not related to CD4+ T cell count. An increase in shedding of HIV- DNA subtype E in female genital tract compared to other HIV subtypes reported by other investigators might be one reason to explain the rapid spread of subtype E by heterosexual transmission in Thailand.

Carbon dioxide laser vaporization for genital wart.

The purpose of this study was to evaluate the effectiveness of carbon dioxide laser vaporization in the treatment of coalescent condyloma acuminata of the female lower genital tract. Between July 1990 and September 1992, 24 cases were enrolled in the study. There were 13 pregnant patients and 11 nonpregnant patients. We performed the procedure under colposcopic guidance on an out-patient basis. Carbon dioxide laser vaporization was carried out in continuity to an appropriate tissue depth with carbon dioxide brushing 1 cm around the lesion. Of these 24 cases, biopsy proven 2 residual lesions and 1 recurrence were documented at the 2nd week and the 2nd month postoperative, respectively. We found low rate of intraoperative and postoperative morbidity or complication, with mild to moderate vulvar pain in the patients and no gross scarring. It is concluded that carbon dioxide laser is effective for eradicating extensive condylomata in the female lower genital tract with low intraoperative and postoperative morbidity on an out-patient basis.

HIV-1 infection among low income women attending a Siriraj sexually transmitted disease clinic: sociodemographic differentials.

From August 1993 to October 1994, 322 women attended or were referred to a female sexually transmitted disease clinic, were studied for the prevalence of HIV infection. No subject had a history of commercial sex work, injection drugs use or blood transfusion within the past 8 years. The majority of women belonged to the low socioeconomic stratum. HIV-1 antibody was found in the sera of 38 women (11.8%). HIV-1 seropositivity was not associated with any type of current sexually transmitted disease such as genital ulcers, serologic markers of syphilis or other sexually transmitted disease as well as history of past sexually transmitted disease within the past 2 years. Significant differential factors were found between the HIV-1 seropositive and seronegative women for self risk assessment and ability to communicate concerns with the husband or partner regarding HIV infection/AIDS. Programs are urgently needed for HIV/AIDS prevention and control to low-income communities and to determine what factors enable the HIV-1 seronegative women to be more assertive in their relationship and whether these skills can be enhanced to eliminate future episodes of STD and transfer these skills to the more vulnerable low-income women. Early diagnosis and prevention of HIV infection among women is a priority for public health interventions both in industrialized and in developing countries.