Genital ulcer disease among STD clinic attenders'in Nairobi: Association with HIV-1 and circumcision status

James M. Nasio, Nico J.D. Nagelkerke, Anthony Mwatha, Stephen Moses, Jackoniah O. Ndinya-Achola, Frank A. Plummer

Research output: Contribution to journalArticlepeer-review

54 Citations (Scopus)


In previous studies, genital ulcers in men have been found to be associated with increased risk of HIV-1 seroconversion. To further explore this association male patients attending a sexually transmitted disease (STD) clinic in Nairobi for either urethritis (controls, n = 276) or a genital ulcer (cases, n = 607) were compared with respect to sexual behaviour, presence of HIV-1 antibody and circumcision status. Patients were followed to study risk factors for incident genital ulcers and HIV-1 seroconversion. At entry, being married was associated with higher prevalence of HIV-1 (OR = 1.76) and genital ulcers (OR = 1.42). Lack of circumcision was associated with both HIV-1 infection (OR = 4.67) and the presence of a genital ulcer (OR = 2.23). Genital ulcers were also associated with HIV-1 infection (OR = 1.87) independent of circumcision status. On follow-up, HIV-1 seropositivity was associated with incident genital ulcers. It is argued that the association between genital ulcers and HIV-1 infection may be more complex than ulcers simply being a risk factor for HIV-1 infection, and that HIV-1 infection may either increase the risk of acquiring a genital ulcer, or HIV-1 infection and genital ulcers may have some unknown risk factor in common.

Original languageEnglish
Pages (from-to)410-414
Number of pages5
JournalInternational Journal of STD and AIDS
Issue number6
Publication statusPublished - 1996
Externally publishedYes


  • Circumcision
  • Genital ulcers
  • HIV
  • Urethritis

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)
  • Infectious Diseases


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