Determinants of Per-Coital-Act HIV-1 Infectivity Among African HIV-1-Serodiscordant Couples

Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. Methods. We analyzed data from a prospective study of African HIV-1-sero...

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Published inThe Journal of infectious diseases Vol. 205; no. 3; pp. 358 - 365
Main Authors Hughes, James P., Baeten, Jared M., Lingappa, Jairam R., Mageret, Amalia S., Wald, Anna, de Bruyn, Guy, Kiarie, James, Inambao, Mubiana, Kilembe, William, Farquhar, Carey, Celum, Connie
Format Journal Article
LanguageEnglish
Published Oxford Oxford University Press 01.02.2012
SeriesEditor's Choice
Subjects
Adult
Africa
Biological and medical sciences
Condoms
Condoms - utilization
Disease transmission
Family Characteristics
Female
Fundamental and applied biological sciences. Psychology
Genotype
Herpes simplex virus 2
HIV
HIV 1
HIV Infections - transmission
HIV Infections - virology
HIV-1 - classification
HIV-1 - genetics
HIV-1 - isolation & purification
HIV/AIDS
Human herpesvirus 2
Human immunodeficiency virus 1
Humans
Infections
Infectious diseases
Major and Brief Reports
Male
Medical sciences
Microbiology
Miscellaneous
Prospective Studies
Research universities
Risk Assessment
RNA
RNA, Viral - genetics
Sexual Behavior - statistics & numerical data
Sexual transmission
Trichomonas vaginalis
Vaginitis
Viral Load
Virology
Africa
Virus
Infection
HIV-1 virus
Infectivity
Retroviridae
Human immunodeficiency virus
Lentivirus
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Abstract Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. Methods. We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner. Results. Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log₁₀ increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]). Conclusions. Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision.
AbstractList Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner. Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]). Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision.
Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. Methods. We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner. Results. Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log₁₀ increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]). Conclusions. Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision.
BACKGROUNDKnowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. METHODSWe analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner. RESULTSOf 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]). CONCLUSIONSModifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision.
(See the editorial commentary by Gray and Wawer on pages 351–2 .) Background .  Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. Methods .  We analyzed data from a prospective study of African HIV-1–serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1–seropositive partners’ reports of number of sex acts and condom use with their study partner. Results .  Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010–.0037) and 0.0010 (95% CI, .00060–.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1–infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1–uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 ( P = .93). Each log 10 increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2–3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11–.42]). Conclusions .  Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1–uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis , vaginitis or cervicitis, and male circumcision.
Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. Methods. We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner. Results. Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log sub(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-42]). Conclusions. Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision.
(See the editorial commentary by Gray and Wawer on pages 351-2.) Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. Methods. We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner. Results. Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log10 increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]). Conclusions. Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision.
Author Farquhar, Carey
Celum, Connie
Kiarie, James
Mageret, Amalia S.
Hughes, James P.
Kilembe, William
Lingappa, Jairam R.
Inambao, Mubiana
de Bruyn, Guy
Baeten, Jared M.
Wald, Anna
AuthorAffiliation 3 Department of Global Health, and
4 Department of Pediatrics, University of Washington, Seattle
5 Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
6 Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg, Republic of South Africa
7 Department of Obstetrics and Gynecology, University of Nairobi and Kenyatta National Hospital, Kenya
10 Department of Laboratory Medicine, University of Washington, Seattle
8 Rwanda-Zambia HIV Research Group (RZHRG), Ndola, Zambia
1 Department of Biostatistics
2 Department of Medicine
9 Department of Epidemiology
AuthorAffiliation_xml – name: 6 Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg, Republic of South Africa
– name: 5 Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
– name: 9 Department of Epidemiology
– name: 1 Department of Biostatistics
– name: 10 Department of Laboratory Medicine, University of Washington, Seattle
– name: 2 Department of Medicine
– name: 3 Department of Global Health, and
– name: 4 Department of Pediatrics, University of Washington, Seattle
– name: 7 Department of Obstetrics and Gynecology, University of Nairobi and Kenyatta National Hospital, Kenya
– name: 8 Rwanda-Zambia HIV Research Group (RZHRG), Ndola, Zambia
Author_xml – sequence: 1
  givenname: James P.
  surname: Hughes
  fullname: Hughes, James P.
– sequence: 2
  givenname: Jared M.
  surname: Baeten
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– sequence: 3
  givenname: Jairam R.
  surname: Lingappa
  fullname: Lingappa, Jairam R.
– sequence: 4
  givenname: Amalia S.
  surname: Mageret
  fullname: Mageret, Amalia S.
– sequence: 5
  givenname: Anna
  surname: Wald
  fullname: Wald, Anna
– sequence: 6
  givenname: Guy
  surname: de Bruyn
  fullname: de Bruyn, Guy
– sequence: 7
  givenname: James
  surname: Kiarie
  fullname: Kiarie, James
– sequence: 8
  givenname: Mubiana
  surname: Inambao
  fullname: Inambao, Mubiana
– sequence: 9
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– sequence: 10
  givenname: Carey
  surname: Farquhar
  fullname: Farquhar, Carey
– sequence: 11
  givenname: Connie
  surname: Celum
  fullname: Celum, Connie
BackLink http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26132776$$DView record in Pascal Francis
https://www.ncbi.nlm.nih.gov/pubmed/22241800$$D View this record in MEDLINE/PubMed
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Copyright Copyright © 2012 Oxford University Press on behalf of the Infectious Diseases Society of America
The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com 2012
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Presented in part: 18th Conference on Retrovirology and Opportunistic Infections, Boston, 27 February–2 March 2011. Paper 135.
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Snippet Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention...
(See the editorial commentary by Gray and Wawer on pages 351-2.) Background. Knowledge of factors that affect per-act infectivity of human immunodeficiency...
Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions...
BACKGROUNDKnowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention...
(See the editorial commentary by Gray and Wawer on pages 351–2 .) Background .  Knowledge of factors that affect per-act infectivity of human immunodeficiency...
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SubjectTerms Adult
Africa
Biological and medical sciences
Condoms
Condoms - utilization
Disease transmission
Family Characteristics
Female
Fundamental and applied biological sciences. Psychology
Genotype
Herpes simplex virus 2
HIV
HIV 1
HIV Infections - transmission
HIV Infections - virology
HIV-1 - classification
HIV-1 - genetics
HIV-1 - isolation & purification
HIV/AIDS
Human herpesvirus 2
Human immunodeficiency virus 1
Humans
Infections
Infectious diseases
Major and Brief Reports
Male
Medical sciences
Microbiology
Miscellaneous
Prospective Studies
Research universities
Risk Assessment
RNA
RNA, Viral - genetics
Sexual Behavior - statistics & numerical data
Sexual transmission
Trichomonas vaginalis
Vaginitis
Viral Load
Virology
Title Determinants of Per-Coital-Act HIV-1 Infectivity Among African HIV-1-Serodiscordant Couples
URI https://www.jstor.org/stable/41417717
https://www.ncbi.nlm.nih.gov/pubmed/22241800
https://search.proquest.com/docview/1654685282
https://search.proquest.com/docview/922215566
https://pubmed.ncbi.nlm.nih.gov/PMC3256946
Volume 205
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