FACTORS ASSOCIATED WITH KAPOSIS-SARCOMA IN A COHORT OF HOMOSEXUAL ANDBISEXUAL MEN

The relationship between the occurrence of Kaposi's sarcoma (KS) and a range of factors was studied in a cohort of homosexual and bisexual m en. Overall, 134 men had AIDS, including 46 for whom KS was the first AIDS-defining illness. The proportion of men diagnosed with AIDS whose first AIDS-defining illness was KS declined from 54 to 24% between 19 84-85 and 1989-90 (p = 0.03 for linear trend). Kaposi's sarcoma was no t associated with a history of any specific communicable disease, nor with the reported use of selected nontherapeutic drugs, at the 0.05 le vel of significance. No single sexual practice was significantly assoc iated with KS, and only the relative risks for insertive oroanal conta ct (1.5, 95% confidence limits 0.73-2.4) and receptive fisting (1.3, 0 .61-2.6) exceeded unity. Kaposi's sarcoma occurred significantly less frequently in men who reported orogenital intercourse than in those wh o did not (relative risk 0.47, 0.23-0.98 for receptive orogenital inte rcourse). History of sexual contact in the United States was associate d with KS, but this association was not statistically significant. Whi le this study provides some support for the hypothesis that Kaposi's s arcoma in people with AIDS may be caused by a sexually transmissible i nfectious agent, no specific sexual practice could be implicated. In p articular, there was little evidence that the postulated KS agent was transmitted by fecal-oral contact.