Association between HIV-2 infection and genital ulcer diseases among male sexually transmitted disease patients in The Gambia

AIDS. 1992 May;6(5):489-93. doi: 10.1097/00002030-199205000-00008.


Objective: To investigate whether genital ulcer diseases are cofactors which enhance the transmission of HIV-2 in West Africa.

Design: A cross-sectional study of 435 men presenting with a sexually transmitted disease (STD).

Setting: The outpatient clinic of the Medical Research Council Laboratories, a primary care facility in Fajara, a suburb of Banjul, the capital city of The Gambia (West Africa).

Patients, participants: Six hundred and twenty-four men presenting with a genital complaint, of whom 443 had an STD. Eight of the men with an STD were excluded from further analysis because they were HIV-1-infected (five patients) or had indeterminate Western blot patterns (three patients). The remaining 21 HIV-2-infected and 414 seronegative men constituted our study-group.

Main outcome measures: Participants were questioned about previous STD and behavioural and demographic characteristics. A physical examination was performed and serum collected for measurement of antibodies against Haemophilus ducreyi and Treponema pallidum.

Results: HIV-2-infected men were more likely than HIV-seronegative participants to have previously had a genital ulcer [odds ratio (OR), 3.00; 95% confidence interval (Cl), 1.18-7.60] and to have antibodies against T. pallidum (OR, 5.95; 95% Cl, 2.10-16.91), or H. ducreyi (OR, 4.59; 95% Cl, 1.71-12.33). Circumcised patients with residual foreskin were more likely to be HIV-2 infected than patients with complete circumcision. HIV-2-seropositive patients were six times more likely to have generalized lymphadenopathy than their seronegative counterparts.

Conclusions: Our data suggest that genital ulcerative diseases, such as syphilis and chancroid, are probably cofactors that increase the transmission of HIV-2 in West Africa, and that HIV-2 infection frequently results in generalized lymphadenopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Gambia / epidemiology
  • Genital Diseases, Male / complications*
  • Genital Diseases, Male / epidemiology
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • HIV-2*
  • Humans
  • Male
  • Middle Aged
  • Regression Analysis
  • Sexually Transmitted Diseases / complications*
  • Skin Ulcer / complications*
  • Skin Ulcer / epidemiology