RISK OF HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION FROM UNPROTECTED RECEPTIVE ANAL INTERCOURSE INCREASES WITH DECLINE IN IMMUNOLOGICAL STATUS OF INFECTED PARTNERS
Gr. Seage et al., RISK OF HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION FROM UNPROTECTED RECEPTIVE ANAL INTERCOURSE INCREASES WITH DECLINE IN IMMUNOLOGICAL STATUS OF INFECTED PARTNERS, American journal of epidemiology, 137(8), 1993, pp. 899-908
To determine whether human immunodeficiency virus (HIV) type 1 infecti
on among unprotected receptive anal partners of HIV type 1-infected me
n varies by the immunologic status of the HIV type 1-infected index ca
se, 187 sexual partners of 164 HIV type 1-infected index subjects were
enrolled at a community health center in Boston, Massachusetts, from
1985-1990. All subjects were interviewed regarding their sexual practi
ces and tested for HIV type 1. Fifty-seven of the 187 sexual partners
were infected with HIV type 1. The strongest risk factor for HIV type
1 infection among these partners was unprotected receptive anal interc
ourse with a known HIV type 1-infected index subject (odds ratio (OR)
= 7.2, 95% confidence interval (CI) 3.1-16.3). The risk of unprotected
receptive anal intercourse was highest among partners of HIV-infected
index subjects who had a T lymphocyte subset ratio of 0.50 or less (O
R = 11.4, 95% Cl 3.0-43.5) compared with partners of HIV type 1-infect
ed index subjects with a T cell ratio of greater than 0.50 (OR = 5.3,
95% Cl 1.9-15.2). After adjustment for confounding, the risk of HIV ty
pe 1 infection remained substantially higher among sexual partners who
had had unprotected receptive anal intercourse with infected index su
bjects with a T lymphocyte subset ratio of less than or equal to 0.50
(OR = 7.0, 95% Cl 1.8-28.0) compared with partners who had had unprote
cted receptive anal intercourse with infected index subjects with a T
cell ratio of greater than 0.50 (OR = 3.3, 95% Cl 1.1-10.0) It would a
ppear that the risk of HIV type 1 infection from unprotected receptive
anal intercourse increases as the immunologic status of the HIV type
1-infected insertive anal partner decreases.