Hayes R J, Schulz K F, Plummer F A
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.
J Trop Med Hyg. 1995 Feb;98(1):1-8.
The goal was to estimate the cofactor effect of genital ulcer disease (GUD) on the risk of HIV transmission during a single heterosexual exposure. The relation between the risk ratio observed in an epidemiological study and the per-exposure cofactor effect was investigated. Given simple assumptions, we show that observed risk ratios are expected to be very much smaller than per-exposure cofactor effects and to decrease as the observation period increases. Data from longitudinal studies of female commercial sex workers and men in Nairobi were reanalysed. The data are consistent with GUD cofactor effects per sexual exposure of 10-50 for male to female transmission, and of 50-300 for female to male transmission. Although subject to wide margins of error, these estimates indicate that GUD may be responsible for a high proportion of heterosexually acquired HIV infections in sub-Saharan Africa, supporting the potential role of STD control as an effective intervention strategy against HIV.
目标是评估生殖器溃疡疾病（GUD）在单次异性接触期间对HIV传播风险的辅助因子效应。研究了在一项流行病学研究中观察到的风险比与每次接触的辅助因子效应之间的关系。基于简单的假设，我们表明观察到的风险比预计会远小于每次接触的辅助因子效应，并且会随着观察期的增加而降低。对内罗毕女性商业性工作者和男性的纵向研究数据进行了重新分析。数据表明，对于男性向女性传播，每次性接触的GUD辅助因子效应为10至50；对于女性向男性传播，该效应为50至300。尽管存在较大误差范围，但这些估计表明，在撒哈拉以南非洲，GUD可能是异性传播HIV感染的很大一部分原因，这支持了将性传播疾病控制作为预防HIV的有效干预策略的潜在作用。
