Risk factors for male to female transmission of HIV. European Study Group.
OBJECTIVE
To identify risk factors for sexual transmission of HIV from infected men to their female sexual partners.


METHODS
Cross sectional analysis as part of a continuing study. Data were obtained by interviewing heterosexual couples in which the man was infected with HIV. Risks were assessed by comparing couples in which transmission had occurred (woman infected with HIV) with those in which it had not (woman not infected) and estimated by independent odds ratios and their 95% confidence intervals.


METHODS
Infectious disease and public health departments from nine centres in six European countries.


METHODS
153 Male index patients (mean age 30.4 years) and their 155 female partners (mean age 27.8 years).


METHODS
Women were tested to determine their HIV antibody state. Women with a risk of infection with HIV other than sexual contact with their infected partner were excluded.


METHODS
Three risk factors for male to female transmission of HIV.


RESULTS
Three risk factors were identified: a history of sexually transmitted disease in the previous five years for the female partner (odds ratio 3.1, 95% confidence interval 1.1 to 8.6); index patient with full blown AIDS (5.4, 1.2 to 25.2); and practice of anal intercourse (5.8, 2.3 to 14.8). The proportion of women positive for HIV antibody was 27% (42/155), ranging from 7% (1 to 13%) (4/60) for couples with none of the three risk factors to 67% (45 to 89%) (12/18) for those with two or three of the risk factors. Duration of the relationship (median three years), frequency of sexual contacts, sexual practices other than anal intercourse, and contraceptive behaviour were not associated with infection of the partner.


CONCLUSIONS
The risk of sexual transmission of HIV from an infected man to his female partner varies considerably according to the characteristics of the couple. The differences in rates of transmission in high risk groups may be considerably reduced if the risk factors are taken into account during individual and public health counselling.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000517:prevention & control / Q000635:transmission*; D000328:Adult; D003268:Contraception Behavior; D003376:Counseling; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006679:HIV Seropositivity / Q000635:transmission; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications; D013997:Time Factors