Spread HIV infection in married monogamous women in India

Raman R. Gangakhedkar, Margaret E. Bentley, Anand D. Divekar, Deepak Gadkari, Sanjay M. Mehendale, Mary E. Shepherd, Robert C. Bollinger, Thomas C. Quinn

Research output: Contribution to journalArticlepeer-review

235 Scopus citations

Abstract

Context.-A high prevalence of human immunodeficiency virus (HIV) infection in female sex workers (FSWs) and men who attend sexually transmitted disease (STD) clinics poses a risk for spread of infection to other populations. Objective.-To examine spread of HIV to a low-risk population by comparing prevalence of, and risk factors for, HIV and STDs in FSWs and non-FSWs. Methods.-Women attending STD clinics in Pune, India, were assessed for STDs and HIV from May 13, 1993, to July 11, 1996. Demographic and behavioral information was collected, and clinical and laboratory assessment was performed. Main Outcome Measure.-Prevalence and risk determinants of HIV infection. Results.-Of 916 women enrolled, 525 were FSWs and 391 were non-FSWs. Prevalence of HIV in FSWs and non-FSWs was 49.9% and 13.6%, respectively (P<.001). In multivariate analysis, inconsistent condom use and genital ulcer disease or genital warts were associated with prevalent HIV in FSWs. History of sexual contact with a partner with an STD was associated with HIV in non-FSWs. Conclusions.-Infection with HIV is increasing in non-FSWs, previously thought to be at low risk in India. Since history of sexual contact with their only sex partner was the only risk factor significantly associated with HIV infection, it is likely that these women are being infected by their spouses. This underscores the need for strengthening partner-notification strategies and counseling facilities in India.

Original languageEnglish (US)
Pages (from-to)2090-2092
Number of pages3
JournalJAMA
Volume278
Issue number23
DOIs
StatePublished - Dec 17 1997

ASJC Scopus subject areas

  • General Medicine

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