Tr. Obrien et al., HETEROSEXUAL TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 FROMTRANSFUSION RECIPIENTS TO THEIR SEX PARTNERS, Journal of acquired immune deficiency syndromes, 7(7), 1994, pp. 705-710
Using lookback procedures and other methods, we identified and then pr
ospectively followed human immunodeficiency virus type 1 (HIV-1)-infec
ted transfusion recipients and their sex partners to determine AIDS in
cidence and risks of heterosexual transmission of HIV-1. At enrollment
, 7 of 32 (21.9%) female partners of male recipients were themselves i
nfected with HIV-1, as compared with none of 14 male partners of femal
e recipients (p = 0.08). No additional episodes of transmission were o
bserved. The prevalence of advanced immunodeficiency at enrollment was
similar in male and female recipients. Male recipients with advanced
immunodeficiency (CD4+ lymphocyte count less than or equal to 0.20 x 1
0(9)/L or a history of clinical AIDS) at enrollment were more likely t
o have infected their female partners (odds ratio = 7.9; p = 0.03) tha
n men with neither condition. Similarly, AIDS-free survival, as estima
ted by the product-limit method, was lower among male transmitters tha
n among male nontransmitters (p = 0.01). Transmission was not associat
ed 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 o
f male-to-female HIV-1 transmission is not explained by a greater numb
er of sexual contacts or more advanced immunodeficiency in index subje
cts.