To the Editor: Dr Osmond and colleagues1 found that the prevalence of Kaposi sarcoma–associated
herpesvirus (KSHV) in 1978 and 1979 was 26.5% among homosexual men who later
enrolled in the San Francisco City Clinic Cohort (SFCCC) study. This finding
is important for understanding the subsequent epidemic of Kaposi sarcoma and
its relationship with human immunodeficiency virus (HIV) in San Francisco.
It was inappropriate, however, for Osmond et al to infer that the incidence
of KSHV has not changed from 1978 through 1996 based on cross-sectional prevalence
data from 3 heterogeneous studies, and to use these data in an ecological
analysis of how behavior change might affect KSHV transmission.
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