Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities

To determine the etiology of genital ulcers and to assess the prevalence of human immunodeficiency virus (HIV) infection in ulcer patients in 10 US ci ties, ulcer and serum specimens were collected from similar to 50 ulcer pat ients at a sexually transmitted disease clinic in each city, Ulcer specimen s were tested using a multiplex polymerase chain reaction assay to detect H aemophilus ducreyi, Treponema pallidum, and herpes simplex virus (HSV); ser a were tested for antibody to HIV, H. ducreyi was detected in ulcer specime ns from patients in Memphis (20% of specimens) and Chicago (12%), T. pallid um was detected in ulcer specimens from every city except Los Angeles (medi an, 9% of specimens; range, 0%-46%), HSV was detected in greater than or eq ual to 50% of specimens from all cities except Memphis (42%), HIV seropreva lence in ulcer patients was 6% (range by city, 0%-18%). These data suggest that chancroid is prevalent in some US cities and that persons with genital ulcers should be a focus of HIV prevention activities.