Martin H L, Nyange P M, Richardson B A, Lavreys L, Mandaliya K, Jackson D J, Ndinya-Achola J O, Kreiss J
Department of Medicine, University of Washington, Seattle 98104-2499, USA.
J Infect Dis. 1998 Oct;178(4):1053-9. doi: 10.1086/515654.
To examine associations between method of contraception, sexually transmitted diseases (STDs), and incident human immunodeficiency virus type 1 (HIV-1) infection, a prospective observational cohort study was done among female sex workers attending a municipal STD clinic in Mombasa, Kenya. Demographic and behavioral factors significantly associated with HIV-1 infection included type of workplace, condom use, and parity. In multivariate models, vulvitis, genital ulcer disease, vaginal discharge, and Candida vaginitis were significantly associated with HIV-1 seroconversion. Women who used depo medroxyprogesterone acetate (DMPA) had an increased incidence of HIV-1 infection (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.4-3.4). In a multivariate model controlling for demographic and exposure variables and biologic covariates, the adjusted HR for HIV-1 infection among DMPA users was 2.0 (CI, 1.3-3.1). There was a trend for an association between use of high-dose oral contraceptive pills and HIV-1 acquisition (HR, 2.6; CI, 0.8-8.5).
为了研究避孕方法、性传播疾病（STD）与新发1型人类免疫缺陷病毒（HIV-1）感染之间的关联，在肯尼亚蒙巴萨一家市级性病诊所就诊的女性性工作者中开展了一项前瞻性观察队列研究。与HIV-1感染显著相关的人口统计学和行为因素包括工作场所类型、避孕套使用情况和生育次数。在多变量模型中，外阴炎、生殖器溃疡疾病、阴道分泌物异常和念珠菌性阴道炎与HIV-1血清转化显著相关。使用醋酸甲羟孕酮（DMPA）的女性HIV-1感染发生率增加（风险比[HR]，2.2；95%置信区间[CI]，1.4 - 3.4）。在控制了人口统计学、暴露变量和生物学协变量的多变量模型中，DMPA使用者中HIV-1感染的校正HR为2.0（CI，1.3 - 3.1）。使用高剂量口服避孕药与HIV-1感染之间存在关联趋势（HR，2.6；CI，0.8 - 8.5）。
