title: Heterosexual transmission of human immunodeficiency virus type 1 from transfusion recipients to their sex partners.
abstract: Using lookback procedures and other methods, we identified and then prospectively followed human immunodeficiency virus type 1 (HIV-1)-infected transfusion recipients and their sex partners to determine AIDS incidence and risks of heterosexual transmission of HIV-1. At enrollment, 7 of 32 (21.9%) female partners of male recipients were themselves infected with HIV-1, as compared with none of 14 male partners of female recipients (p = 0.08). No additional episodes of transmission were observed. The prevalence of advanced immunodeficiency at enrollment was similar in male and female recipients. Male recipients with advanced immunodeficiency (CD4+ lymphocyte count < or = 0.20 x 10(9)/L or a history of clinical AIDS) at enrollment were more likely to have infected their female partners (odds ratio = 7.9; p = 0.03) than men with neither condition. Similarly, AIDS-free survival, as estimated by the product-limit method, was lower among male transmitters than among male nontransmitters (p = 0.01). Transmission was not associated with frequency of unprotected vaginal intercourse. Our data suggest that HIV-1-infected men who develop immunodeficiency rapidly are more likely to infect their sex partners and that the greater efficiency of male-to-female HIV-1 transmission is not explained by a greater number of sexual contacts or more advanced immunodeficiency in index subjects.
authors.affiliation: Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: T R
authors.initials: TR
authors.lastname: O'Brien
authors.forename: M P
authors.initials: MP
authors.lastname: Busch
authors.forename: E
authors.initials: E
authors.lastname: Donegan
authors.forename: J W
authors.initials: JW
authors.lastname: Ward
authors.forename: L
authors.initials: L
authors.lastname: Wong
authors.forename: S M
authors.initials: SM
authors.lastname: Samson
authors.forename: H A
authors.initials: HA
authors.lastname: Perkins
authors.forename: R
authors.initials: R
authors.lastname: Altman
authors.forename: R L
authors.initials: RL
authors.lastname: Stoneburner
authors.forename: S D
authors.initials: SD
authors.lastname: Holmberg
mesh_terms: D000328:Adult; D000367:Age Factors; D001803:Blood Transfusion; D017280:Condoms; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000209:etiology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012189:Retrospective Studies; D012725:Sexual Behavior; D012747:Sexual Partners; D013997:Time Factors