[Prevalence of HIV-1 and other sexually transmitted diseases among Spanish prostitutes]. / Prevalencia de VIH-1 y otras enfermedades de transmisión sexual en prostitutas españolas.

BACKGROUND: Many studies in Western countries point to the high prevalence of HIV infection in groups of prostitutes especially among those using intravenous drugs (IVDA). Furthermore, there appears to be a low but increasing number of heterosexually infected prostitutes. METHODS: A cross-sectional study was carried out in a sample of 374 prostitutes selected by collaborating groups in 11 provinces with the aim of studying the prevalence of HIV and its associated risk factors in Spanish prostitutes. Furthermore, the prevalence of other sexually transmitted diseases (HIV-2, HTLV-I/II, hepatitis B and syphilis), the frequency of different sexual activities and the use of condoms were investigated in this group. The data were collected by interview using a previously tested questionnaire. RESULTS: Serological analysis demonstrated that 54 persons were positive for HIV-1 (16%), none for HIV-2, 1 for HTLV-I/II, 113 for hepatitis B (46%) and 84 for syphilis (25%). The main risk factor for HIV infection was IVDA; 60% of this group was positive vs 3% of the non IVDA (OR = 47.6; confidence interval 18.4-128.0). Consistent condom use in this population is low, although it varies according to the type of relation and sexual partner. Forty-nine percent of the women having vaginal relations with their customers reported using condoms at all times or almost all times vs 36% for anal relations and 22% for oral relations. These percentages were reduced to 10%, 6% and 3%, respectively with private sexual partners. CONCLUSIONS: Studies concerning HIV prevalence and its associated risk factors in Spanish prostitutes should be continued in order to monitor trends in HIV infection and the use of protective measures.

[Risk factors for the heterosexual transmission of HIV from man to woman: a Spanish multicenter study]. / Factores de riesgo para la transmisión heterosexual del VIH de varón a mujer: un estudio multicéntrico español.

BACKGROUND: The aims of this study were to estimate the rate of heterosexual transmission of HIV in a population of intravenous drug users (IVDU), as to well as to identify the possible risk factors associated. METHODS: One hundred thirty heterosexual couples were analyzed in which the male was seropositive for the human immunodeficiency virus (HIV) with the only possible risk factor for the companion being the sexual intercourse with the case index. RESULTS: The rate of global transmission estimated was 16% (confidence interval of 95% = 10-22.4%). The risk factors significantly associated to HIV transmission were: case index of over 30 years of age (OR = 3.1), clinical status IV (OR = 4.1), less than 0.8 x 10(8) lymphocytes/I (OR = 7), antecedents of sexually transmitted disease (STD) in the woman (OR = 4), and the practice of anal intercourse (OR = 3.1). In the multivariate analysis only the clinical status of the case index and the STC antecedents of the woman were statistically significant (p less than 0.05). CONCLUSIONS: In this study some of the classical risk factors for the heterosexual transmission of HIV have been confirmed, and the importance of decreasing the prevalence of STD in the IVDU collective in Spain has been corroborated to lower heterosexual transmission and, indirectly the vertical transmission of AIDS.

PIP: The objectives of this study, which formed part of the Multicenter European Study of Heterosexual Transmission, were to estimate the rate of heterosexual HIV transmission in a population of intravenous drug users, to describe the sexual and contraceptive habits of the couples, and to identify possible risk factors for heterosexual HIV transmission. 130 couples from 17 centers in Andalusia, Cataluna, and Madrid, who met the criteria and agreed to participate, were studied between June 1988 and February 1990. The index case in all couples was a male partner seropositive for HIV infection. Exclusion criteria for the female partner included intravenous drug use, blood transfusion since 1980, or sexual relations in the past 6 months with an individual other than the index case. All women were screened for HIV antibodies with the ELISA test, with confirmation of positive results by Western blot or indirect immunofluorescence. Around 70% of participants in center collecting sociodemographic information were illiterate of had primary educations, and over half had children. 40% of the index cases had a history of sexual contacts with prostitutes, over 20% reported more than 5 sexual partners in the past 5 years, and 18% had had other sexual partners in addition to the partner interviewed since learning of their seropositivity. Over half of couples had been together for more than 5 years. 32% of the women reported other sexual partners in the past 5 years, excluding the past 6 months. 70% of the couples interviewed reported having sexual relations 1-3 times weekly. 25% reported having anal intercourse. 33% of the men and 17% of the women reported a history of sexually transmitted diseases. 11 additional cases of sexually transmitted disease in men and 8 in women were diagnosed in the study. The rate of transmission was 16% (21/130), with a 95% confidence interval between 10-22.4%. The risk factors significantly associated with HIV transmission were: index case over 30 years old (odds ratio of 3.1), clinical stage 4 (odds ratio 4.1), lymphocyte level under 800 (odds ratio of 7), history of sexually transmitted diseases in the woman (odds ratio of 4), and practice of anal intercourse (odds ratio of 3.1). The clinical stage of the index case and history of sexually transmitted disease in the woman were the only risk factors statistically significant in multivariate analysis. The lymphocyte population was omitted from the multivariate analysis, since it was known for only 63 men. The possible effect of condom use could not be determined because only 4 couples used them regularly.

The use of AIDS surveillance data for short-term prediction of AIDS cases in Madrid, Spain.

The paper presents a preliminary attempt to predict the numbers of AIDS cases in the Community of Madrid (CAM) up to 1992. Using AIDS case surveillance data gathered by CAM, and a statistical procedure that includes a distribution for reporting delays, the numbers of new diagnoses, reports, AIDS deaths and numbers of patients alive is predicted. Approximate confidence limits for the numbers of new diagnoses are given. We emphasise that these predictions are tentative given the nature of the reporting delays, and discuss the use of such predictions and the requirements for their improvement.

Genetic analysis of cystic fibrosis: linkage of DNA and classical markers in multiplex families.

Linkage of cystic fibrosis (CF) to DNA and classical markers was studied in 36 families of two or three generations with at least two living affected children. Among the 79 affected children, no recombinants were detected between the disease and the markers MET and pJ3.11, previously shown to be linked to CF. No linkage between the human trypsin gene family (which appears to include at least 10 members) and CF was found, although not all genes of the trypsin family have been screened yet. In one of the CF families, recombination between MET and pJ3.11 was detected in an unaffected sib. Data from our families suggest that the gene order of markers among chromosome 7q is: (7cen;p8.33)collagen(COL1A2);DOCR1-917;paraoxonase+ ++(PON);(MET-cf-J3.11);T-cell receptor beta chain (TCRB);qter. There was no evidence for (or against) either postzygotic selection or meiotic drive to explain the high frequency of CF in Caucasian populations.