RISK-FACTORS FOR HTLV-I AMONG HETEROSEXUAL STD CLINIC ATTENDERS

Human T-cell lymphotropic virus type 1 (HTLV-1) status was assessed in 994 patients attending a sexually transmitted disease (STD) clinic in Kingston, Jamaica, between November 1990 and January 1991 for a new S TD complaint, Of 515 heterosexual men, 36 (7.0%) were HTLV-1 seroposit ive, as were 38 (7.9%) of 479 women. HTLV-1 seroprevalence increased w ith age in women. A history of blood transfusion was associated with H TLV-1 in both sexes, significantly so in men [odds ratio (OR) 4.7, con fidence interval (CI) 1.1-17 for men; OR 1.9, CI 0.6-5.0 for women]. F urther analysis excluded all persons reporting a transfusion. On multi ple logistic regression analysis, independent associations with HTLV-1 infection in men were shown for marital status (OR 3.5, CI 1.2-10 for married/common law vs, single/visiting unions), agricultural occupati on (OR 9.0, CI 2.0-41), bruising during sex (OR 2.9, CI 1.0-8.1), grea ter than or equal to 15 years at first sexual intercourse (OR 2.9, CI 1.0-8.2), and a positive test for hepatitis B surface antigen (OR 7.3, CI 1.2-52). In women, associations were shown for two or more sex par tners in the 4 weeks prior to complaint (OR 4.9, CI 1.8-13), 11 or mor e lifetime sexual partners (OR 5.9, CI 1.3-27), aged <15 years at firs t sexual intercourse (OR 2.3, 1.0-5.4), bruising during sex (OR 2.7, C I 1.1-6.6), microhaemagglutination-Treponema pallidum positivity (OR 3 .6, CI 1.6-8.4), and human immunodeficiency virus infection (OR 14, CI 2.1-92). STDs and bruising during sex may facilitate sexual transmiss ion of HTLV-1, whereas sexual activity is a more important risk factor in women than men. Programs promoting safer sexual practices and cont rolling STDs may reduce HTLV-1 infection in Jamaica.