Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
THE EPIDEMIOLOGY OF AIDS: HOMOSEXUAL MEN
The Epidemiology of AIDS: Expression, Occurrence, and Control of Human Immunodeficiency Virus Type 1 Infection. Kaslow RA and Francis DP, eds. New York, Oxford University Press, p. 117-35, 1989.. Unique Identifier : AIDSLINE ICDB/90668114 Winkelstein W Jr; Padian NS; Rutherford G; Jaffe HW; Univ. of California, Berkeley, Sch. of Public Health, Berkeley,; CA 94720
Abstract:
Because AIDS was discovered first in homosexual men and this group has been the most heavily affected, much of what is known about AIDS and its etiologic agent has been learned from studies in this group. AIDS in homosexual men is reviewed, including historical background; epidemiology of AIDS and HIV-1 infection (occurrence, geographic distribution, age and racial ethnic characteristics of those with AIDS, prevalence of HIV-1 infection, and incidence of HIV-1 infection); modes of transmission (sexual and blood transfer); infectivity of HIV-1 among homosexual men; cofactors for HIV-1 infection (ancillary sexual practices and concurrent or prior infections); and natural history of HIV-1 infection in homosexual men. By the end of 1987, the AIDS epidemic, first recognized in homosexual men in 1981, had affected more than 35,000 of them in the United States alone, and almost 20,000 of these individuals had died. These cases and deaths represented more than 70% of the total in the United States since the beginning of the epidemic. Approx 80% of all cases in homosexual men in the United States have occurred in nine states and the District of Columbia. Prevalence of HIV-1 infection in a selected population of homosexual men in San Francisco was 5% in 1978 and had reached approx 70% by 1985. Figures in other US cities generally were lower. The vast majority of HIV-1 infections are due to sexual contact. Because infectivity of HIV-1 is relatively low and the major role of transmission, penile-anal intercourse, has been determined, effective control of the spread of HIV-1 infection has been possible. Homosexual men have reduced substantially their numbers of different sexual partners and their frequency of high-risk practices. Presumably, they also have increased their use of condoms. The natural history of HIV-1 infection can be divided into three stages. The primary stage, from infection through seroconversion, is characterized by an acute mononucleosis-like syndrome and usually lasts no more than a few weeks. The secondary stage, from seroconversion until the onset of AIDS, has a variable duration of months to years. Clinical manifestations of HIV-1 infection during this stage of the infection vary from trivial to serious. The tertiary stage, from the time AIDS develops, lasts only about 1 yr, during which time untreated patients rapidly and almost invariably progress to death. (72 Refs)
Keywords: Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/PREVENTION & CONTROL/*TRANSMISSION Adult Cross-Sectional Studies *Disease Outbreaks *Homosexuality/STATISTICS & NUMER DATA Human HIV-1/*PATHOGENICITY Incidence Male Middle Age Risk Factors Sex Behavior United States/EPIDEMIOLOGY MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
