Sexual network distributions of STIs and HIV in relation to "core groups".
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. C10403)
Friedman SR, Maslow C, Bolyard M, Mateu-Gelabert P, Sandoval M National Development and Research Institutes, New York, United States
Background : Sexual networks and STIs are predictors of HIV transmission. IDUs and MSM are a core group for many STIs. We studied viral STIs among core group members, their sexual partners (SPs), and other local adults. Methods : 165 IDUs, 29 MSM/IDUs, 21 other MSM were designated as the "core group" based on previous research. 68 sexual partners of MSM and/or IDUs, and 137 other adults were recruited in Bushwick, Brooklyn, New York in 2002 - 2003. Interviews were held and blood and urine specimens collected and tested for STIs including HIV, HSV-2 and HBV. Hepatitis B "vaccinated" were defined as those with detectable HBsAb but without either HBcAb or HbsAg; HBV "exposure" was defined as HbcAb+ and/or HbsAg+. Results : In the core group, 19% were HIV+; 60% herpes simplex virus type 2 +; 61% hepatitis B exposed among the unvaccinated and 19% vaccinated among the unexposed. Among those who were neither IDUs nor MSM: 1) HIV prevalence was higher among SPs than among other adults (7% vs. 0.7%; p.0429). 2) Hepatitis B exposure among the unvaccinated was higher among SPs than among other adults (23% vs 8%; p.0209); and vaccination among the never-infected was lower among SPs (15% vs 46%; p.0006). 3) HSV-2 prevalence was higher among SPs than among other adults (58% vs. 33%; p.0019) (and similar [57%] among 14 sex partners of SPs). Differences between SPs and other adults remained significant after controlling for sex work in the prior year. Conclusions : HIV prevalence among those who are neither core group members nor direct SPs of core group members remains low. More highly infectious viruses (HSV-2 and HBV) may have spread more widely from these core groups or from other sources. MSM, IDUs and their SPs may be core groups for the spread of HSV-2 as well as for HIV, posing co-infection risks for further HIV spread. STI diagnosis, treatment and prevention for IDUs, MSM and their sex partners are a crucial part of HIV prevention.
Keywords: AEGIS, HIV Seropositivity, Acquired Immunodeficiency Syndrome, Prevalence, Hepatitis B, Sexual Partners, AIDS Serodiagnosis, Hepatitis B Antibodies, New York, Adult, immunology, diagnosis
