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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Inhibiting sexual transmission of HIV-1 infection
Robin J. Shattock,John P. Moore +1 more
TL;DR: How increasing knowledge of the ways in which HIV-1 is transmitted is shaping the development of new, more sophisticated intervention strategies based on the application of vaginal or rectal microbicides is discussed.
Journal ArticleDOI
Community-based approaches to HIV treatment in resource-poor settings.
Paul Farmer,Fernet Leandre,Joia S. Mukherjee,Marie Sidonise Claude,Patrice Nevil,Mary C. Smith-Fawzi,Serena P. Koenig,Arachu Castro,Mercedes C. Becerra,Jeffrey D. Sachs,Amir Attaran,Jim Yong Kim +11 more
TL;DR: It is shown that it is possible to carry out an HIV treatment programme in a poor community in rural Haiti, and it is suggested that directly-observed therapy of chronic infectious disease with multidrug regimens can be highly effective in settings of great privation as long as there is sustained commitment to uninterrupted care that is free to the patient.
Journal ArticleDOI
A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known?
TL;DR: A large body of work has measured the association between STDs and HIV, but publication bias and gaps in the focus of studies mean that a detailed, quantitative understanding of the interaction requires much more attention.
Journal ArticleDOI
Sexual behavior of HIV discordant couples after HIV counseling and testing.
Susan Allen,Jareen Meinzen-Derr,Michele Kautzman,Isaac Zulu,Stanley A. Trask,Ulgen Fideli,Rosemary Musonda,Francis Kasolo,Feng Gao,Alan Haworth +9 more
TL;DR: Joint VCT prompted sustained but imperfect condom use in HIV discordant couples, and biological markers were insensitive but provided evidence for a significant under-reporting of unprotected sex.
Journal ArticleDOI
Male circumcision for prevention of heterosexual acquisition of HIV in men
TL;DR: This review evaluates the results of three randomised controlled trials, which analysed the effectiveness and safety of male circumcision for preventing acquisition of HIV in heterosexual men, and formulated a comprehensive and exhaustive search strategy to identify all relevant studies.
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
Sexual transmission of HIV
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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