Nelson K E, Celentano D D, Suprasert S, Wright N, Eiumtrakul S, Tulvatana S, Matanasarawoot A, Akarasewi P, Kuntolbutra S, Romyen S
Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
JAMA. 1993 Aug 25;270(8):955-60.
To determine the sociodemographic and behavioral risk factors associated with human immunodeficiency virus (HIV) infection in two cohorts of young men selected for military service in northern Thailand.
Military conscripts were studied cross-sectionally after conscription in May 1991 and November 1991. Risk factors were assessed by interview with trained nonmilitary interviewers.
Two military training bases in Chiang Mai, Thailand.
A total of 2417 young men aged 19 to 23 years (mean age, 21 years) conscripted by lottery into military service in the Royal Thai Army or Royal Thai Air Force from six provinces in northern Thailand.
Human immunodeficiency virus seroprevalence by enzyme-linked immunosorbent assay confirmed by Western blot and univariate and multivariate analyses of sociodemographic and behavioral risk factors associated with HIV seroprevalence.
Overall, 289 (12.0%) of 2417 men were HIV-seropositive at baseline. The strongest associations with being HIV positive were heterosexual activities. History of sex with a female commercial sex worker (CSW) was frequent (96.5% of men who were HIV-positive and 79.0% of men who were HIV-negative) and strongly associated with HIV infection on univariate and multivariate analyses (adjusted odds ratio, 1.60 to 2.07, depending on the frequency of CSW contact). Also, sexually transmitted diseases were common and associated with HIV infection in both univariate and multivariate analyses (adjusted odds ratio, 3.36). Sex with other males and injection drug use were uncommon and not associated with HIV infection. Condom use was reported in 61.5% of men at last sex with a CSW but was not shown to be protective of prevalent HIV infection.
The epidemic of HIV infection has spread widely among young men in northern Thailand, despite reported frequent and recent use of condoms during sex with female CSWs. Control of HIV infection in this population will probably require more regular and effective use of condoms, prevention and treatment of sexually transmitted diseases, and reduction in the frequency of CSW contact.
确定泰国北部两组应征入伍的年轻男性中与人类免疫缺陷病毒（HIV）感染相关的社会人口统计学和行为风险因素。
于1991年5月和1991年11月征兵后对新兵进行横断面研究。通过与经过培训的非军事访谈人员进行访谈来评估风险因素。
泰国清迈的两个军事训练基地。
从泰国北部六个省份通过抽签应征进入泰国皇家陆军或泰国皇家空军服役的2417名年龄在19至23岁（平均年龄21岁）的年轻男性。
通过蛋白质印迹法确认的酶联免疫吸附测定法检测的人类免疫缺陷病毒血清阳性率，以及与HIV血清阳性率相关的社会人口统计学和行为风险因素的单变量和多变量分析。
总体而言，2417名男性中有289名（12.0%）在基线时HIV血清呈阳性。与HIV阳性关联最强的是异性性行为。与女性商业性工作者（CSW）发生性行为的历史很常见（HIV阳性男性中的96.5%和HIV阴性男性中的79.0%），并且在单变量和多变量分析中与HIV感染密切相关（调整后的优势比为1.60至2.07，取决于与CSW接触的频率）。此外，性传播疾病很常见，并且在单变量和多变量分析中都与HIV感染相关（调整后的优势比为3.36）。与其他男性发生性行为和注射吸毒并不常见，且与HIV感染无关。在最后一次与CSW发生性行为的男性中，61.5%报告使用了避孕套，但未显示出对现患HIV感染有保护作用。
尽管报告称在与女性CSW发生性行为期间经常且近期使用避孕套，但HIV感染在泰国北部的年轻男性中已广泛传播。控制该人群中的HIV感染可能需要更规律和有效地使用避孕套、预防和治疗性传播疾病以及减少与CSW接触的频率。
