FEASIBILITY OF HUMAN-IMMUNODEFICIENCY-VIRUS VACCINE TRIALS IN HOMOSEXUAL MEN IN THE UNITED-STATES - RISK BEHAVIOR, SEROINCIDENCE, AND WILLINGNESS TO PARTICIPATE

Human immunodeficiency virus (HIV)-seronegative high-risk homosexual m en were enrolled in a vaccine feasibility study in three US cities, HI V seroincidence was 2.3/100 person-years (95% confidence interval [CI] , 1.7-2.9) over 18 months in 1975 men. After receiving an explanation of I-W vaccine trial design, 37% stated they were ''definitely'' willi ng to participate in future trials; seroincidence was 3.7/100 person-y ears (95% CI, 2.5-4.9) in this subgroup, An additional 57% ''might be' ' or were ''probably'' willing. Independent predictors of HIV seroconv ersion in multivariable pooled logistic regression analysis were havin g a known HIV-seropositive sex partner (odds ratio [OR], 4.5; 95% CI, 2.6-7.8), injection drug use (OR, 3.6; 95% CI, 1.2-10.7), unprotected receptive anal sex (OR, 2.4; 95% CI, 1.4-4.2), condom failure (OR, 2.4 ; 95% CII 1,4-4,1), gonococcal/nongonococcal urethritis (OR, 2.3; 95% CI, 1.1-4.7), and age <25 years (OR, 2.2; 95% CI, 1.2-4.2). Interest i n vaccine trials and seroincidence in high-risk homosexual men are suf ficiently high to initiate efficacy trials once a suitable candidate v accine is identified, Risk factors for seroconversion highlight import ant areas for development of ancillary intervention strategies.