A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.

<h4>Background</h4>Approximately 2.4 million people are living with HIV in India. This large disease burden, and potential for epidemic spread in some areas, demands a full understanding of transmission in that country. We wished to quantify the effects of key sexual risk factors for HIV...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Paul Arora, Nico J D Nagelkerke, Prabhat Jha
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b7208b94b2d04c0a9ab57eae8f7a119a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b7208b94b2d04c0a9ab57eae8f7a119a
record_format	dspace
spelling	oai:doaj.org-article:b7208b94b2d04c0a9ab57eae8f7a119a2021-11-18T07:07:25ZA systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.1932-620310.1371/journal.pone.0044094https://doaj.org/article/b7208b94b2d04c0a9ab57eae8f7a119a2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22937158/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Approximately 2.4 million people are living with HIV in India. This large disease burden, and potential for epidemic spread in some areas, demands a full understanding of transmission in that country. We wished to quantify the effects of key sexual risk factors for HIV infection for each gender and among high- and low-HIV risk populations in India.<h4>Methodology</h4>We conducted a systematic review of sexual risk factors for HIV infection from 35 published studies. Risk factors analyzed were: male circumcision/religion, Herpes Simplex Virus 2, syphilis, gonorrhoea, genital ulcer, multiple sexual partners and commercial sex. Studies were included if they met predetermined criteria. Data were extracted and checked by two researchers and random-effects meta analysis of effects was conducted. Heterogeneity in effect estimates was examined by I(2) statistic. Publication bias was tested by Begg's test and funnel plots. Meta regression was used to assess effect modification by various study attributes.<h4>Results</h4>All risk factors were significantly associated with HIV status. The factor most strongly associated with HIV for both sexes was HSV-2 infection (OR(men): 5.87; 95%CI: 2.46-14.03; OR(women): 6.44; 95%CI: 3.22-12.86). The effect of multiple sexual partners was similar among men (OR = 2.46; 95%CI: 1.91-3.17,) and women (OR = 2.02; 95%CI: 1.43-2.87) and when further stratified by HIV-risk group. The association between HSV-2 and HIV prevalence was consistently stronger than other STIs or self-reported genital ulcer. If the strong associations between HSV-2 and HIV were interpreted causally, these results implied that approximately half of the HIV infections observed in our study population were attributable to HSV-2 infection.<h4>Conclusions</h4>The risk factors examined in our analysis should remain targets of HIV prevention programs. Our results confirm that sexual risk factors for HIV infection continue to be an important part of Indian HIV epidemic 26 years after it began.Paul AroraNico J D NagelkerkePrabhat JhaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e44094 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Paul Arora Nico J D Nagelkerke Prabhat Jha A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.
description	<h4>Background</h4>Approximately 2.4 million people are living with HIV in India. This large disease burden, and potential for epidemic spread in some areas, demands a full understanding of transmission in that country. We wished to quantify the effects of key sexual risk factors for HIV infection for each gender and among high- and low-HIV risk populations in India.<h4>Methodology</h4>We conducted a systematic review of sexual risk factors for HIV infection from 35 published studies. Risk factors analyzed were: male circumcision/religion, Herpes Simplex Virus 2, syphilis, gonorrhoea, genital ulcer, multiple sexual partners and commercial sex. Studies were included if they met predetermined criteria. Data were extracted and checked by two researchers and random-effects meta analysis of effects was conducted. Heterogeneity in effect estimates was examined by I(2) statistic. Publication bias was tested by Begg's test and funnel plots. Meta regression was used to assess effect modification by various study attributes.<h4>Results</h4>All risk factors were significantly associated with HIV status. The factor most strongly associated with HIV for both sexes was HSV-2 infection (OR(men): 5.87; 95%CI: 2.46-14.03; OR(women): 6.44; 95%CI: 3.22-12.86). The effect of multiple sexual partners was similar among men (OR = 2.46; 95%CI: 1.91-3.17,) and women (OR = 2.02; 95%CI: 1.43-2.87) and when further stratified by HIV-risk group. The association between HSV-2 and HIV prevalence was consistently stronger than other STIs or self-reported genital ulcer. If the strong associations between HSV-2 and HIV were interpreted causally, these results implied that approximately half of the HIV infections observed in our study population were attributable to HSV-2 infection.<h4>Conclusions</h4>The risk factors examined in our analysis should remain targets of HIV prevention programs. Our results confirm that sexual risk factors for HIV infection continue to be an important part of Indian HIV epidemic 26 years after it began.
format	article
author	Paul Arora Nico J D Nagelkerke Prabhat Jha
author_facet	Paul Arora Nico J D Nagelkerke Prabhat Jha
author_sort	Paul Arora
title	A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.
title_short	A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.
title_full	A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.
title_fullStr	A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.
title_full_unstemmed	A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.
title_sort	systematic review and meta-analysis of risk factors for sexual transmission of hiv in india.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/b7208b94b2d04c0a9ab57eae8f7a119a
work_keys_str_mv	AT paularora asystematicreviewandmetaanalysisofriskfactorsforsexualtransmissionofhivinindia AT nicojdnagelkerke asystematicreviewandmetaanalysisofriskfactorsforsexualtransmissionofhivinindia AT prabhatjha asystematicreviewandmetaanalysisofriskfactorsforsexualtransmissionofhivinindia AT paularora systematicreviewandmetaanalysisofriskfactorsforsexualtransmissionofhivinindia AT nicojdnagelkerke systematicreviewandmetaanalysisofriskfactorsforsexualtransmissionofhivinindia AT prabhatjha systematicreviewandmetaanalysisofriskfactorsforsexualtransmissionofhivinindia
_version_	1718423937133576192

A systematic review and meta-analysis of risk factors for sexual transmission of HIV in India.

Ejemplares similares