American Journal of Epidemiology Vol. 128, No. 4: 729-739
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
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RISK FACTORS FOR HTV INFECTION IN MALE SEXUAL CONTACTS OF MEN WITH AIDS OR AN AIDS-RELATED CONDITION
1 Department of Preventive Medicine and Biostatistics, Faculty of Medicine, University of Toronto Toronto, Ontario, Canada, M5S 1A8
2 Department of Medicine, Faculty of Medicine, University of Toronto Toronto, Ontario, Canada
3 Department of Pediatrics, Faculty of Medicine, University of Toronto Toronto, Ontario, Canada
4 Department of Microbiolo Faculty of Medicine, University of Toronto Toronto, Ontario, Canada
5 Department of Immunology, Faculty of Medicine, University of Toronto Toronto, Ontario, Canada
6Department of Health Services Administration and Community Miedicine, University of Alberta Edmonton, Alberta, Canada.
Reprint requests to Dr. Randall Coates at this address
A total of 246 healthy male sexual contacts of men with either acquired immunodeficiency syndrome (AIDS) or an AIDS-related condition were recruited into a prospective study in Toronto, Canada between July 1984 and July 1985. At induction, data were collected on the sexual relationship between the contact and his primary case, sexual activities with other men, history of sexually transmitted diseases and other diseases, and use of recreational drugs. At recruitment, 144 sexual contacts had antibodies to human immunodeficiency virus (HIV); 102 of the contacts were seronegative at induction and at three months following recruitment. No association between HIV seropositivity and total number of sexual partners could be demonstrated. In univariate and multivariate analyses, receptive and insertive anal intercourse with the primary cases, and activities which either indicated or potentially caused anorectal mucosal injury (rectal douching, perianal bleeding, receipt of objects in ano, and receptive fisting) were strongly associated with HIV seropositivity. in the final multiple logistic regression model, two significant interaction effects were observed: the interaction between receptive anal intercourse and insertive anal intercourse and that between receptive anal intercourse and the anorectal mucosal injury index. These two interaction terms had negative regression coefficients which suggested that change in one sexual activity would not decromentally reduce risk of HIV infection without a comparable modification in the other activity. No association could be demonstrated between oral-genital and oral-anal sexual contact and odds ratios for these sexual activities declined to levels below 1.0 when adjusted for frequency of receptive anal intercourse.
acquired immunodeficiency syndrome; homosexuallty; human immunodeficiency viruses; sex behavior
Ontario Ministry of Health and Grant No. 6606-2587-54, National Health Research and Development Program, Health and Welfare, Canada Dr. Coates is supported by a National Health Research Scholar Award, Health and Welfare, Canada. Dr. Fanning is supported by a Career Scientist Award, Ontario Ministry of Health.
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