Human herpesvirus 8 can be transmitted through blood in drug addicts.

Human Herpes virus type-8 (HHV-8) seroprevalence was studied in a population of HIV positive intravenous drug users (IVDUs) from Argentina. Analysis of this population also indirectly made it possible to study HHV-8 blood transmission, because these individuals frequently engage in needle sharing behavior and are capable of acquiring a broad array of blood borne pathogens, including Hepatitis B/C virus. The seroprevalence of HHV-8 in IVDUs was compared to a group of non-IVDUs and HIV negative individuals. Of the 223 individuals tested, 13.45% were HHV-8 positive, 16.99% in the IVDUs group, and 5.71% in the non-IVDUs. Among HIV positive IVDUs, 25/144 (17.36%) were also HHV-8 seropositive. The seropositivity rate of HHV-8 in HIV negative IVDUs was 11.1%. In contrast, HHV-8 seroprevalence in HIV negative heterosexual individuals without drug usage behavior was even lower (5.71%). The rate of HHV-8 infection in HIV positive IVDUs was three times as high compared to the non IVDU HIV negative individuals, suggesting that IVDU is a risk for HHV-8 infection. Furthermore, it was found that IVDUs showed a very high rate of Hepatitis B/C (52.77%), which also correlate with HHV-8 infection in this population (23.68%). All Hepatitis B/C positive individuals were also HIV positive. Our data confirm other studies showing that individuals who share needles are at risk for acquiring Hepatitis B/C and HIV infections. In addition, our results suggest that they are also at risk to acquiring HHV-8 infection by the same route.

Human herpesvirus 8 can be transmitted through blood in drug addicts.

Human Herpes virus type-8 (HHV-8) seroprevalence was studied in a population of HIV positive intravenous drug users (IVDUs) from Argentina. Analysis of this population also indirectly made it possible to study HHV-8 blood transmission, because these individuals frequently engage in needle sharing behavior and are capable of acquiring a broad array of blood borne pathogens, including Hepatitis B/C virus. The seroprevalence of HHV-8 in IVDUs was compared to a group of non-IVDUs and HIV negative individuals. Of the 223 individuals tested, 13.45

were HHV-8 positive, 16.99

in the IVDUs group, and 5.71

in the non-IVDUs. Among HIV positive IVDUs, 25/144 (17.36

) were also HHV-8 seropositive. The seropositivity rate of HHV-8 in HIV negative IVDUs was 11.1

. In contrast, HHV-8 seroprevalence in HIV negative heterosexual individuals without drug usage behavior was even lower (5.71

). The rate of HHV-8 infection in HIV positive IVDUs was three times as high compared to the non IVDU HIV negative individuals, suggesting that IVDU is a risk for HHV-8 infection. Furthermore, it was found that IVDUs showed a very high rate of Hepatitis B/C (52.77

), which also correlate with HHV-8 infection in this population (23.68

). All Hepatitis B/C positive individuals were also HIV positive. Our data confirm other studies showing that individuals who share needles are at risk for acquiring Hepatitis B/C and HIV infections. In addition, our results suggest that they are also at risk to acquiring HHV-8 infection by the same route.

HIV-related high risk sexual behaviors and practices among women in Bogotá, Colombia.

Determinants associated with high-risk sexual behaviors were investigated in 1,133 sexually active women in Bogotá, Colombia. A self-administered questionnaire was completed by two groups of women: 721 representing the general population (GP), and 412 commercial sex workers (CSWs). High-risk sexual behaviors for HIV/AIDS were evident in both groups. Nevertheless, consistent condom use was reported by only 6% of the GP group, as compared to 67% of the CSWs. Failure to recognize high-risk routes for HIV infection was indicated in 69% of the GP women for anal sex, and by the majority of both groups for intercourse during menses (56% GP women and 54% CSWs). Multivariate analysis revealed that education level, actual age, and age of first sex experience were significant predictors of high-risk sexual practices. The necessity for educational programs regarding high-risk sexual practices and risk of HIV/ AIDS is evident for HIV/AIDS prevention.

Differences in HIV-risk behaviours among recidivists and persons with their first episode of an STD in Guyana

OBJECTIVE: To ascertain differences in HIV-risk behaviour patterns between recidivists and persons having their first episode of an STD. DESIGN AND METHODS: A cross-sectional survey was conducted among 300 consecutive persons who complained of a new STD. RESULTS: 164/300 (55 percent) persons were recidivists while 136 (45 percent) were persons with their first STD episode. Recidivists were more likely to be males odds ratio (OR=1.89; 95 percent CI: 1.16-3.09) and Afro-Guyanese (OR=3.8; 95 percent CI: 1.96-5.50). As compared to recidivists, persons with their first STD episode were more likely to be younger, <20 years old, (23.4 percent vs. 8.8 percent; p=0.009). No significant differences were found between recidivists and first-timers with respect to educational attainment and marital status. As compared to the first-timers, recidivists were significantly less likely to report condom use (OR=0.56; 95 percent CI: 0.31-0.99) and two times more likely to report having had sex for money (OR=2.22; 95 percent CI: 1.23-5.32). No significant differences were found between recidivists and first-timers with respect to mean age of first sexual intercourse and mean number of partners during the past 12 months. Recidivists were more likely to report alcohol use (76.2 percent vs. 58. percent; p=0.003) and use of marijuana (23.2 percent vs. 16.3 percent; p=0.176). CONCLUSIONS: Recidivists were more likely to engage in high-risk sexual behaviour patterns, indicating that they should be targeted by HIV-prevention programmes that focus on the reduction of high-risk sexual practices.(Au)

Drug use and syphilis. Co-factors for HIV transmission among commercial sex workers in Guyana.

A cross-sectional survey was conducted among 124 street- and brothel-based female commercial sex workers (CSWs) in Georgetown in January and February 1997 to determine the seroprevalence of human immunodeficiency virus (HIV) infection and describe the sexual practices and drug use patterns. Their median age was 30 years (range 17 to 52 years). 119 (88%) reported regular alcohol consumption while looking for clients, 27 (22%) said they smoked cocaine and 51 (42%) reported use of marijuana. Street-based CSWs were significantly more likely to report marijuana use (p = 0.033). 72% reported that they never used condoms with regular sex partners and 35% reported that they never used condoms with clients. Brothel-based women were significantly more likely to report consistent condom use with their clients (p = 0.05). 46% (54/118) tested HIV positive and 28% (33/118) had a positive serological test for syphilis. Factors that were significantly associated with HIV infection included a positive serological test for syphilis (OR = 7.56; 95% CI = 2.7-21.97; p < 0.01) and a history of having received treatment for syphilis (OR = 2.93; 95% CI = 1.12-7.8). Weak associations were also found between HIV infection and a history of cocaine use (OR = 2.57; 95% CI = 0.95-7.11; p = 0.039); having more than four clients per night (OR = 5.14; 95% CI = 1.65-16.74; p = 0.04); and a history of receiving treatment for salpingitis (OR = 2.31; 95% CI = .93-5.75; p = 0.0035). No statistically significant association was found between HIV infection and marijuana use nor any sociodemographic variables (age, place of work, and duration of sex work). There is an urgent need for a community based behavioural intervention programme targetting this high risk population.

Drug use and syphilis: co-factors for HIV transmission among commercial sex workers in Guyana

A cross-sectional survey was conducted among 124 street-and brothel-based female commercial sex workers (CSWs) in Georgetown in January and February 1997 to determine the seroprevalence of human immunodeficiency virus (HIV) infection and describe the sexual practices and drug use patterns. Their median age was 30 years (range 17 to 52 years). 119 (88 percent) reported regular alcohol consumption while looking for clients, 27 (22 percent) said they smoked cocaine and 51 (42 percent) reported use of marijuana. Street-based CSWs were significantly more likely to report marijuana use (p = 0.033). 72 percent reported that they never used condoms with regular sex partners and 35 percent reported that they never used condoms with clients. Brothel-based women were significantly more likely to report consistent condom use with their clients (p = 0.05). 46 percent (54/118) tested HIV positive and 28 percent (33/118) had a positive serological test for syphilis. Factors that were significantly associated with HIV infection included a positive serological test for syphilis (OR = 7.56; 95 percent CI = 2.7-21.97; p < 0.01) and a history of having received treatment for syphilis (OR = 2.93; 95 percent CI = 1.12-7.8). Weak associations were also found between HIV infection and a history of cocaine use (OR = 2.57; 95 percent CI = 0.95-7.11; p = 0.039); having more than four clients per night (OR = 5.14; 95 percent CI = 1.65-16.74; p = 0.04; and a history of receiving treatment for salpingitis (OR = 2.31; 95 percent CI = 0.93-5.75; p = 0.0035). No statistically significant association was found between HIV infection and marijuana use nor any sociodemographic variables (age, place of work, and duration of sex work). There is an urgent need for a community based behavioural intervention programme targetting this high risk population (AU)

Drug use and syphilis. Co-factors for HIV transmission among commercial sex workers in Guyana

A cross-sectional survey was conducted among 124 street- and brothel-based female commercial sex workers (CSWs) in Georgetown in January and February 1997 to determine the seroprevalence of human immunodeficiency virus (HIV) infection and describe the sexual practices and drug use patterns. Their median age was 30 years (range 17 to 52 years). 119 (88) reported regular alcohol consumption while looking for clients, 27 (22) said they smoked cocaine and 51 (42) reported use of marijuana. Street-based CSWs were significantly more likely to report marijuana use (p = 0.033). 72reported that they never used condoms with regular sex partners and 35reported that they never used condoms with clients. Brothel-based women were significantly more likely to report consistent condom use with their clients (p = 0.05). 46(54/118) tested HIV positive and 28(33/118) had a positive serological test for syphilis. Factors that were significantly associated with HIV infection included a positive serological test for syphilis (OR = 7.56; 95CI = 2.7-21.97; p < 0.01) and a history of having received treatment for syphilis (OR = 2.93; 95CI = 1.12-7.8). Weak associations were also found between HIV infection and a history of cocaine use (OR = 2.57; 95CI = 0.95-7.11; p = 0.039); having more than four clients per night (OR = 5.14; 95CI = 1.65-16.74; p = 0.04); and a history of receiving treatment for salpingitis (OR = 2.31; 95CI = .93-5.75; p = 0.0035). No statistically significant association was found between HIV infection and marijuana use nor any sociodemographic variables (age, place of work, and duration of sex work). There is an urgent need for a community based behavioural intervention programme targetting this high risk population.

Epidemiology of non-ulcerative sexually transmitted diseases in a high risk population in Jamaica

The role of ulcerative STDs such as syphilis in facilitating the transmission and acquisition of HIV is well established. Non-ulcerative STDs such as gonorrhoea and Chlamydia infection are considered facilitators of HIV transmission. This study was designed to determine the types of non-ulcerative sexually transmitted diseases and associated risk factors among high-risk Jamaican men and women. A cross-sectional survey was conducted including 510 clients attending an STD clinic in Kingston. A standardised questionnaire was administered and microbiological investigations performed on urethral or cervical swab specimens obtained from each participant. All the subjects were symptomatic; 377 (74 percent) had genital discharge and 197 (39 percent) had dysuria with or without discharge. There were 309 cases of NGU; 115 cases of Candidiasis, 275 confirmed gonococcal infections and 226 cases of Trichomoniasis. Men were two times more likely to have gonococcal infection than women (69 percent vs. 50 percent; p<0.01). History of smoking marijuana was significantly associated with a positive test for gonorrhoea (69 percent vs. 52 percent; p<0.01). Forty one percent of women reported that their partners never used condoms (41 percent vs. 19 percent; p<0.01). Only nine men acknowledged consistent condom use. Those who were first time attendees at the STD clinic (n=263) were more likely to report never using condoms (38 percent vs. 27 percent; p<0.01). These data highlight the need for priority targetting in this high-risk group for counselling and health education in controlling, STD and HIV infection in Jamaica.(AU)

Increased prevalence of Plasmodium falciparum malaria in Honduras, Central America.

We report on our investigation of a malaria outbreak in Honduras, Central America, in January 1997. We tested 202 patients with fever and chills using thin and thick blood film microscopy. Sixteen patients lived in the city and the rest lived in rural areas. A total of 95 samples (47%) were positive for malaria parasites. Seventy-nine percent (63/80) of the rural patients were infected with Plasmodium vivax and 21% (17/80) were infected with P. falciparum. In the urban area, all 15 infected patients had P. vivax malaria and none showed evidence of P. falciparum. Since previous reports indicate that falciparum malaria accounts for only 2% of the overall malaria infections in Honduras, the results reported here suggest that there is a dramatic increase in falciparum malaria in the area of Honduras investigated in this study.

Human herpesvirus 8 as a potential sexually transmitted agent in Honduras.

The seroprevalence of human herpesvirus 8 (HHV-8) was studied in 326 human immunodeficiency virus (HIV)-positive and -negative persons from Honduras; women constituted 77% (n = 251) of the subjects. Sera were tested for lytic HHV-8 antibodies by an IFA, and positive samples were confirmed by a radioimmunoprecipitation assay. Of the 326 persons tested, 58 (17.8%) had HHV-8 antibodies. Among the HIV-infected women, 22.7% were seropositive; 11.3% of the HIV-negative women were seropositive. HHV-8 seroprevalence was almost four times higher in HIV-positive female commercial sex workers (36%) than in HIV-negative female non-commercial sex workers (9.9%; odds ratio = 3.8, 95% confidence interval = 1.1-13; P = 0.01), suggesting that commercial sex work is a risk factor for HHV-8 infection. In the men studied, the overall HHV-8 seroprevalence was 22.6%, with a seropositivity rate of 28% for HIV-positive men compared with 12% for HIV-negative men.

Prevalence of viral and bacterial sexually transmitted pathogens in Jamaican pregnant women.

In this study we investigated the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, human immunodeficiency virus type I (HIV-I), human T cell lymphotropic virus type 1 (HTLV-1) and hepatitis B virus (HBV) infections in 200 pregnant women attending antenatal clinics at the University Hospital of the West Indies. 19% of the women had at least one pathogen: C. trachomatis was found in 16%, HTLV-1 in 2%, HIV-1, HBV and N. gonorrhoeae each in 0.5% C. trachomatis infection was more prevalent in women less than 20 years of age (31%) than in those 20 years and older (16%; OR = 0.43; chi 2 = 5.66; p < 0.05). The study demonstrates the need for identification of sexually transmitted pathogens in antenatal women for syndromic management of genital infections as part of the strategy for prevention and control of HIV/AIDS (acquired immunodeficiency syndrome) in Jamaica.

Intestinal parasitic infections in human immunodeficiency virus (HIV)-positive and HIV-negative individuals in San Pedro Sula, Honduras.

Honduras has at least five-times more human immunodeficiency virus (HIV)-infected individuals than any other country in Central America. The relationship between HIV status and the presence of intestinal parasites in this part of the world is unknown. This study presents the results from a prospective, comparative study for the presence of parasites in 52 HIV-positive and 48 HIV-negative persons in San Pedro Sula, Honduras. Infection with HIV was determined by microagglutination and confirmed by Western blot analysis. Parasites were detected in stools using formalin-ether concentration, and Kinyoun and trichrome staining. Age, sex, and clinical state of HIV infection were recorded for each study participant. Our results indicate that Cryptosporidium parvum and Strongyloides stercoralis, which are intracellular or live in the mucosa, were found exclusively in persons infected with HIV. In comparison, the prevalence of the extracellular parasites Giardia lamblia, Ascaris lumbricoides, and Trichuris trichiura was significantly higher (P < 0.05) in persons who were HIV-negative. Trichuris worms are in contact with the gut epithelium and less so with the mucosa, whereas Strongyloides lives within the gut mucosa. It is possible that changes in the gut epithelium due to HIV infection do not affect the mucosa and therefore would not affect Strongyloides. We conclude that infection with HIV may selectively deter the establishment of certain intestinal parasites. This may be due to the fact that HIV-induced enteropathy does not favor the establishment of extracellular parasites. Intracellular and mucosal dwelling organisms, however, may benefit from pathologic changes and reduced local immune responses induced by the virus, which, in turn, may lead to higher prevalence among HIV-infected individuals.

HIV seropositivity and associated factors among female commercial sex workers in Guyana

To determine the prevalence of, and risk factors for, HIV infection among female commercial sex workers in Guyana a cross sectional survey was done among 124 streetwalkers and brothel based female sex workers in Georgetown during January and February, 1997. The mean age was 30.6 years (range = 17 to 52; sd = 7.24). Sixty-one percent said they had worked in the sex industry for 1 to 4 years while 30 percent indicated they had worked for >4 years. Forty-six percent (54/118) tested HIV positive while 28 percent (33/118) had a positive serological test for syphilis. Factors that were significantly associated with HIV infection included a positive serological test for syphilis (OR = 7.56; 95 percent CI = 2.7 - 21.97, p<0.01), a history of cocaine use (OR = 2.57, 95 percent CI = 0.95 - 7.11, p = 0.039), having > 4 clients per night (OR = 5.14, 95 percent CI = 1.65 - 16.74, p = 0.04), a history of having received treatment for syphilis (OR = 2.93, 95 percent CI = 1.12 - 7.8, p = 0.0035) and a history of receiving treatment for salpingitis (OR = 2.31, 95 percent CI = 0.93. 95 percent CI = 1.12 - 7.8, p = 0.0035) and a history of receiving treatment for salpingitis (OR = 2.31, 95 percent CI = 0.93 - 5.75, p = 0.0035). These results show a high prevalence of HIV infection and inconsistent condom use among the participants of the study. Exposure to syphilis seems to be a major risk factor for HIV. There is an urgent need for an integrated and innovative internvention targeting this high risk population. (AU)

Prevalence of viral and bacterial sexually transmitted pathogens in Jamaican pregnant women

In this study we investigated the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, human immunodeficiency virus type I (HIV-I), human T cell lymphotropic virus type 1 (HTLV-1) and hepatitis B virus (HBV) infections in 200 pregnant women attending antenatal clinics at the University Hospital of the West Indies. 19of the women had at least one pathogen: C. trachomatis was found in 16, HTLV-1 in 2, HIV-1, HBV and N. gonorrhoeae each in 0.5C. trachomatis infection was more prevalent in women less than 20 years of age (31) than in those 20 years and older (16; OR = 0.43; chi 2 = 5.66; p < 0.05). The study demonstrates the need for identification of sexually transmitted pathogens in antenatal women for syndromic management of genital infections as part of the strategy for prevention and control of HIV/AIDS (acquired immunodeficiency syndrome) in Jamaica.

Correlates of HIV infection among women attending a sexually transmitted disease clinic in Guyana - abstract

A prospective study was conducted among 351 women who attended the Genitourinary Medical clinic in Georgetown for the first time between February and April, 1993 to determine the prevalence of HIV infection and describe the factors associated with HIV infection among these women. Information on demographics, sexual behaviour and medical and reproductive history was collected using a structured questionnaire. Blood samples were collected for testing HIV (320), syphilis (335) and Hepatitis B (318). HIV seropositivity was observed in 6.6 percent (21/320). 3.1 percent (10/318) tested positive for Hepatitis B surface antigen and 18.5 percent (68/335) had a positive serologic test for syphilis. The HIV seropositivity rate was significantly higher among single women (8.7 percent vs 2.6 percent, p=0.035) and women who thought they were at risk of HIV (9.9 percent vs 2.7 percent, p=0.0097). 6.95 percent of the women who lived in Georgetown tested positive for HIV compared to 6.01 percent of those who lived outside of Georgetown (p=0.75). 8.9 percent of those women who reported ever having used a condom tested HIV positive as compared to 5.5 percent of women who never used a condom. The prevalence of HIV infection did not vary significantly with age (p=0.299) nor level of education (p=0.476). Conclusion: This study demonstrated a high prevalence of HIV infection among women attending a sexually transmitted disease clinic in Guyana. These findings indicate that any effective strategy for the control of HIV spread in Guyana must include targeting of STD clinic attenders(AU)