BEHAVIORAL AND DEMOGRAPHIC RISK-FACTORS FOR TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 IN HETEROSEXUAL COUPLES - REPORT FROM THE HETEROSEXUAL HIV TRANSMISSION STUDY

We compared 224 heterosexual couples who were discordant for human imm unodeficiency virus (HIV) type 1 infection (one partner HIV infected) with 78 HIV-concordant couples (both partners HIV infected) to identif y 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 knowi ng that the male was infected than had HIV-discordant couples, Pap sme ars of grade 2 or higher (inflammation) were more prevalent among the second-infected female partners in HIV-concordant couples than among u ninfected women in discordant couples (58% vs. 23%; P <.001). Anal sex and unprotected vaginal sex after knowledge of a male partner's infec tion were significant correlates of concordance in a multivariate logi stic model, as were ethnicity, marital status, and antiviral therapy. Ethnicity strongly predicted concordance, even after controlling for s exual risk behaviors and stage of disease.