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1996-01-30
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Document 0058
DOCN M9610058
TI A case-control study of human immunodeficiency virus type 1
seroconversion and risk-related behaviors in the Chicago MACS/CCS
Cohort, 1984-1992. Multicenter AIDS Cohort Study. Coping and Change
Study.
DT 9601
AU Ostrow DG; DiFranceisco WJ; Chmiel JS; Wagstaff DA; Wesch J; Department
of Psychiatry and Behavioral Medicine, Medical College; of Wisconsin,
Milwaukee 53202, USA.
SO Am J Epidemiol. 1995 Oct 15;142(8):875-83. Unique Identifier : AIDSLINE
MED/96017411
AB This paper focuses on 76 human immunodeficiency virus type 1 (HIV-1)
seroconverters who concurrently participated in the Chicago, Illinois,
component of the Multicenter AIDS Cohort Study (MACS) and the Coping and
Change Study (CCS) of homosexual/bisexual men between 1984 and 1992. A
nested case-control analysis was performed to assess the critical
behavioral risk factors associated with incident HIV-1 infection and the
consistency of these relations in early (1984-1988) versus later
(1989-1992) phases of the study. Univariate results revealed strong
early period associations between seroconversion and various measures of
receptive anal intercourse (RAI) that became considerably weaker in the
study's later period. The weaker associations reflected the overall
decline in levels of RAI among the cohort during the 9 years of
observation. In contrast, univariate results revealed stronger later
period associations between seroconversion and measures of receptive
oral intercourse and insertive anal intercourse. Subsequent multivariate
testing did not support the hypothesis that receptive oral intercourse
and/or insertive anal intercourse have replaced unprotected RAI as
important risk behaviours in the homosexual transmission of HIV-1. In
conditional logistic regression models combining intercourse measures
with indices of drug and condom use, only the latter variables were
consistently associated with HIV-1 seroconversion in both early and
later study periods. Adjusted odds ratios (ORs) for nonuse of condoms
during RAI were consistently significant throughout the study (ORs =
3.7-4.8), while adjusted odds ratios for recreational drug use variables
rose dramatically during the latter half of the study (e.g., for use of
cocaine, OR = 81.3 (95% confidence interval 0-824), and for use of
nitrite poppers, OR = 9.1 (95% confidence interval 1.8-45.5)). The
behavioral intervention applications of these findings, as well as their
relation to data from other recent cohort studies of HIV-1
seroconversion among homosexual/bisexual men, are discussed.
DE Analysis of Variance *Bisexuality Case-Control Studies
Chicago/EPIDEMIOLOGY Cohort Studies Health Behavior *Homosexuality,
Male Human HIV Seropositivity/BLOOD/PSYCHOLOGY/*TRANSMISSION
*HIV-1/IMMUNOLOGY Logistic Models Male Risk Factors Support, U.S.
Gov't, P.H.S. JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).