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American Journal of Epidemiology Vol. 140, No. 8: 747-758
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Determinants of HIV Disease Progression among Homosexual Men Registered in the Tricontinental Seroconverter Study

Paul J. Veugelers1,, Kimberly A. Page2, Brett Tindall3, Martin T. Schechter4, Andrew R. Moss5, Warren W. Winkelstein, Jr.2, David A. Cooper3, Kevin J. P. Craib4, Edwin Charlebois5, Roel A. Coutinho1 and Godfried J. P. van Griensven1

1Municipal Health Service, Department of Public Health Amsterdam, The Netherlands
2School of Public Health, University of California Berkeley, CA
3National Center on HIV Epidemiology and Clinical Research, University of New South Wales Sydney, NSW, Australia
4Department for Health Care and Epidemiology, University of British Columbia, St. Paul's Hospital Vancouver, BC, Canada
5Department of Epidemiology and Biostatistics, San Francisco General Hospital San Francisco, CA

Reprint requests to Paul J. Veugelers, Tricontinental Seroconverter Study Group, Municipal Health Service, Department of Public Health, P. O. Box 20244, 1000 HE Amsterdam, The Netherlands

Data on 403 homosexual/bisexual men with documented dates of human immunodeficiency virus (HIV) seroconversion were merged. All subjects originated from cohort studies that started between 1982 and 1984 in Amsterdam, The Netherlands; San Francisco, California; Sydney, Australia; and Vancouver, British Columbia, Canada. With respect to the four geographic locations, no statistically significant differences in progression time from HIV seroconversion to acquired immunodeficiency syndrome (AIDS) and death as well as in AIDS diagnoses patterns could be demonstrated. The median time from HIV seroconversion to AIDS was 8.3 years, that from HIV serocon version to death was 8.9 years, and that from AIDS to death was 17 months. The authors evaluated HIV disease progression with respect to demographic, clinical, and behavioral cofactors. Younger age and use of prophylaxis against Pneumocystis carinii pneumonia were significantly related to slower progression from seroconversion to death. In addition, an association between slower progression and earlier dates of seroconversion was found. No relation of sexual behavior; history of sexually transmitted diseases; or use of alcohol, tobacco, and recreational drugs with rates of disease progression could be demonstrated.

acquired immunodeficiency syndrome; HIV; homosexuality; sex behavior


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