title: Behavioral and demographic risk factors for transmission of human immunodeficiency virus type 1 in heterosexual couples: report from the Heterosexual HIV Transmission Study.
abstract: We compared 224 heterosexual couples who were discordant for human immunodeficiency virus (HIV) type 1 infection (one partner HIV infected) with 78 HIV-concordant couples (both partners HIV infected) to identify demographic and behavioral risk factors for HIV transmission. Among the 229 couples whose male partner was first infected, HIV-concordant couples had engaged in anal sex more frequently before and after knowing that the male was infected than had HIV-discordant couples. Pap smears of grade 2 or higher (inflammation) were more prevalent among the second-infected female partners in HIV-concordant couples than among uninfected women in discordant couples (58% vs. 23%; P < .001). Anal sex and unprotected vaginal sex after knowledge of a male partner's infection were significant correlates of concordance in a multivariate logistic model, as were ethnicity, marital status, and antiviral therapy. Ethnicity strongly predicted concordance, even after controlling for sexual risk behaviors and stage of disease.
authors.affiliation: Department of Preventive Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Skurnick
authors.forename: C A
authors.initials: CA
authors.lastname: Kennedy
authors.forename: G
authors.initials: G
authors.lastname: Perez
authors.forename: J
authors.initials: J
authors.lastname: Abrams
authors.forename: S H
authors.initials: SH
authors.lastname: Vermund
authors.forename: T
authors.initials: T
authors.lastname: Denny
authors.forename: T
authors.initials: T
authors.lastname: Wright
authors.forename: M A
authors.initials: MA
authors.lastname: Quinones
authors.forename: D B
authors.initials: DB
authors.lastname: Louria
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners; D019966:Substance-Related Disorders