Monday, January 23, 2012

HIV Transmission per Coital Act

An accurate estimate of HIV transmission per episode of heterosexual intercourse is not easy to measure. Here is a study of the highest importance recently published in the Journal of Infectious Diseases that accomplishes what was presumed impossible.

Several important points:
  • The participants were 3297 African (heterosexual) couples
  • Overall HIV infectivity was 1-2 cases per 1000 coital acts
  • The HIV viral load was in the infected partner was associated with increased transmission risk (2.9 fold adjusted rsk of infection per Log10 increment in viral load)
  • There was a 2.14 fold increased risk of transmission if the uninfected partner was Herpes Simplex Virus 2 infected
  • There was 2.65 fold increased risk of transmission if the uninfected partner had genital ulcer disease 
  • Transmission was significantly reduced if the HIV infected partner was on HIV treatment, if condoms were used, and if the male was circumcised
These findings support the strategies of early diagnosis, prompt treatment of HIV and associated sexually transmitted diseases, male circumcision and condom promotion.

Common sense interventions, driven by data.

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