Journal ArticleDOI
Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1
Thomas C. Quinn,Maria J. Wawer,Nelson K. Sewankambo,David Serwadda,Chuanjun Li,Fred Wabwire-Mangen,Mary Meehan,Tom Lutalo,Ronald H. Gray +8 more
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TLDR
The viral load is the chief predictor of the risk of heterosexual transmission of HIV-1, and transmission is rare among persons with levels of less than 1500 copies of HIV -1 RNA per milliliter.Abstract:
Background and Methods We examined the influence of viral load in relation to other risk factors for the heterosexual transmission of human immunodeficiency virus type 1 (HIV-1). In a community-based study of 15,127 persons in a rural district of Uganda, we identified 415 couples in which one partner was HIV-1–positive and one was initially HIV-1–negative and followed them prospectively for up to 30 months. The incidence of HIV-1 infection per 100 person-years among the initially seronegative partners was examined in relation to behavioral and biologic variables. Results The male partner was HIV-1–positive in 228 couples, and the female partner was HIV-1–positive in 187 couples. Ninety of the 415 initially HIV-1–negative partners seroconverted (incidence, 11.8 per 100 person-years). The rate of male-to-female transmission was not significantly different from the rate of female-to-male transmission (12.0 per 100 person-years vs. 11.6 per 100 person-years). The incidence of seroconversion was highest among ...read more
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Journal ArticleDOI
Treatment to Prevent Transmission of HIV-1
TL;DR: The data supporting the use of ART to prevent HIV transmission is reviewed and the public health implications of this strategy are critically examined.
Journal ArticleDOI
The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya
TL;DR: Acceptability of male circumcision as a means to reduce STDs and HIV is higher than previously suspected in the Luo, a large, traditionally non-circumcising ethnic group in western Kenya.
Journal ArticleDOI
Living with discordance: knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda.
Bunnell Re,J. Nassozi,Marum E,Mubangizi J,Samuel S. Malamba,Dillon B,Kalule J,J. Bahizi,N. Musoke,Mermin Jh +9 more
TL;DR: Improved counseling protocols that clearly explain discordance, emphasize high risk of transmission, and support risk reduction are urgently needed for HIV-discordant couples in Uganda.
Journal ArticleDOI
Integrating HIV prevention and treatment: from slogans to impact
Joshua A. Salomon,Daniel R Hogan,John Stover,Karen A Stanecki,Neff Walker,Neff Walker,Peter D. Ghys,Bernhard Schwartländer +7 more
TL;DR: The importance of integrating expanded care activities with prevention activities if there are to be long-term reductions in the number of new HIV infections and significant declines in AIDS mortality is demonstrated.
Journal ArticleDOI
Late marriage and the HIV epidemic in sub-Saharan Africa
TL;DR: The hypothesis of a link between a high average age at marriage and a long period of premarital intercourse during which partner changes are relatively common and facilitate the spread of HIV is supported.
References
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From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection.
TL;DR: It is suggested that timely provision of STD services can substantially reduce HIV incidence, but raise additional questions about the optimal way to target and implement these services to achieve the greatest effect on HIV transmission.
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Journal ArticleDOI
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TL;DR: The epidemiology and biology of the host-related factors that affect the sexual transmission of HIV and the host susceptibility and infectiousness environment biologic agent are discussed.
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