title: Seminal Shedding of CMV and HIV Transmission among Men Who Have Sex with Men.
abstract: As in many urban areas in the United States, the largest burden of the HIV epidemic in San Diego is borne by men who have sex with men (MSM). Using data from well-characterized HIV transmitting and non-transmitting partner pairs of MSM in San Diego, we calculated the population attributable risk (PAR) of HIV transmissions for different co-infections common among MSM in this area. We found that over a third of HIV transmissions could be potentially attributed to genital shedding of cytomegalovirus (CMV) (111 transmission events), compared to 21% potentially attributed to bacterial sexually transmitted infections (STI) (62 events) and 17% to herpes simplex virus type-2 (HSV-2) (51 events). Although our study cannot infer causality between the described associations and is limited in sample size, these results suggest that interventions aimed at reducing CMV shedding might be an attractive HIV prevention strategy in populations with high prevalence of CMV co-infection.
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. gianella@ucsd.edu.
authors.forename: Sara
authors.initials: S
authors.lastname: Gianella
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. kscheffler@ucsd.edu.|Department of Mathematical Sciences, Stellenbosch University, Stellenbosch 7602, South Africa. kscheffler@ucsd.edu.
authors.forename: Konrad
authors.initials: K
authors.lastname: Scheffler
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. srmehta@ucsd.edu.
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Mehta
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. slittle@ucsd.edu.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Little
authors.affiliation: County of San Diego Public Health Services, CA 92105, USA. lorri.freitas@sdcounty.ca.gov.
authors.forename: Lorri
authors.initials: L
authors.lastname: Freitas
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. srmehta@ucsd.edu.
authors.forename: Sheldon R
authors.initials: SR
authors.lastname: Morris
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA. d13smith@ucsd.edu.|Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA. d13smith@ucsd.edu.
authors.forename: Davey M
authors.initials: DM
authors.lastname: Smith
mesh_terms: D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000635:transmission*; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology
keywords: HIV epidemics; HIV transmission; cytomegalovirus; men who have sex with men