HIV heterosexual transmission: a hypothesis about an additional potential determinant.

Journal Article (Journal Article)

Transmission rates of human immunodeficiency virus (HIV) during heterosexual intercourse vary dramatically around the world. In Asia and South America, they are extraordinarily high, whereas in the United States and Europe, rates are much lower even after a large number of unprotected contacts. The transmission rates in Africa also probably are high, but the available studies unfortunately are weak. In Thailand, female-to-male transmission rates per contact were estimated at.056 (l in 18) compared to.0002 to.0015 (1/5000-1. 5/1000) for male-to-female transmission in the United States and Europe. Male-to-female transmission in Thailand appears to show, as expected, even greater transmission likelihood compared to female-to-male rates. In general, in the United States and Europe, transmission rates within heterosexual couples range from less than 10% to 22%, whereas in Thailand and Brazil, the rates exceed 40%. The much lower transmission rate per contact in the United States and Europe is based on an assumption that HIV transmitters are a homogeneous group. Wiley and colleagues argue that transmitters are likely to be a heterogeneous group with a large percentage of very low frequency transmitters and a small percentage of high frequency transmitters. That hypothesis is given some support by a cluster of cases in rural New York State in which one man appeared to infect 31% of his many contacts.

Full Text

Duke Authors

Cited Authors

  • Louria, DB; Skurnick, JH; Palumbo, P; Bogden, JD; Rohowsky-Kochan, C; Denny, TN; Kennedy, CA

Published Date

  • 2000

Published In

Volume / Issue

  • 4 / 2

Start / End Page

  • 110 - 116

PubMed ID

  • 10737850

International Standard Serial Number (ISSN)

  • 1201-9712

Digital Object Identifier (DOI)

  • 10.1016/s1201-9712(00)90105-x


  • eng

Conference Location

  • Canada