Behavioral and Demographic Risk Factors for Transmission of Human Immunodeficiency Virus Type 1 in Heterosexual Couples: Report from the Heterosexual HIV Transmission Study

• Published in: Clinical infectious diseases Vol. 26; no. 4; pp. 855 - 864
• Main Authors: Skurnick, Joan H., Kennedy, Cheryl A., Perez, George, Abrams, Judith, Vermund, Sten H., Denny, Thomas, Wright, Thomas, Quinones, Mark A., Louria, Donald B.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-04-1998; University of Chicago Press
• Subjects: Adult; Aged; AIDS; Alcohol Drinking; Biological and medical sciences; Clinical Articles; Condoms; Ethnicity; Female; Heterosexual transmission; Heterosexuality; HIV; HIV Infections - transmission; HIV-1; Human immunodeficiency virus 1; Human sexual behavior; Human viral diseases; Humans; Infections; Infectious diseases; Male; Medical sciences; Men; Middle Aged; Multivariate Analysis; Predisposing factors; Prospective Studies; Risk Factors; Sexual Partners; Sexually transmitted diseases; Substance-Related Disorders; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Human; Immunopathology; HIV-1 virus; Heterosexuality; Sexual behavior; Transmission; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Viral disease; Risk factor; Human immunodeficiency virus
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/513929

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 secondinfected 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.