HIV-1 seroconversion in patients with and without genital ulcer disease. A prospective study

Ann Intern Med. 1993 Dec 15;119(12):1181-6. doi: 10.7326/0003-4819-119-12-199312150-00005.


Objective: To determine the relative risk for human immunodeficiency virus (HIV-1) seroconversion in patients with and without genital ulcers caused by chancroid, syphilis, and herpes.

Design: A prospective cohort study.

Setting: An inner-city, sexually transmitted disease clinic.

Patients: Patients seronegative for HIV-1 with and without genital ulcers who were followed for a minimum of 3 months.

Interventions: Questionnaire to obtain data on demographics, sexual behavior, and illicit drug use; testing for HIV-1 at entry and at a minimum of 3 months after entry; medical examination for the presence or absence of genital ulcer disease.

Results: Overall, 758 heterosexual men with no history of injection drug use completed the study; HIV-1 seroconversion occurred in 10 of 344 (2.9%; 95% CI, 1.4% to 5.3%) men with a genital ulcer and in 4 of 414 (1%; CI, 0.2% to 2.5%) without a genital ulcer (relative risk, 3.0; P = 0.05). In a multiple logistic regression analysis, those men with chancroid and a new sexually transmitted disease during follow-up each had about three times the risk for HIV-1 seroconversion (P < or = 0.04).

Conclusions: In this group of heterosexual men, chancroid and repeated acquisition of sexually transmitted diseases appeared to facilitate the sexual transmission of HIV-1.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Female
  • Genital Diseases, Female / complications*
  • Genital Diseases, Female / etiology
  • Genital Diseases, Male / complications*
  • Genital Diseases, Male / etiology
  • HIV Seropositivity / complications
  • HIV Seropositivity / transmission*
  • HIV-1*
  • Humans
  • Male
  • Prospective Studies
  • Regression Analysis
  • Risk Factors
  • Sexual Behavior
  • Sexually Transmitted Diseases / complications*
  • Substance-Related Disorders / complications
  • Ulcer / complications
  • Ulcer / etiology