Heterosexual transmission of human immunodeficiency virus type 1 from transfusion recipients to their sex partners.
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.
O'Brien
T R
TR
Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia.
Busch
M P
MP
Donegan
E
E
Ward
J W
JW
Wong
L
L
Samson
S M
SM
Perkins
H A
HA
Altman
R
R
Stoneburner
R L
RL
Holmberg
S D
SD
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