Rates of HIV‐1 Transmission per Coital Act, by Stage of HIV‐1 Infection, in Rakai, Uganda

Bibliographic Data

ID23388907
AuthorsMaria J Wawer (0000-0002-3601-4469, Columbia University, corresponding author), Ronald H Gray (0000-0003-1952-6507, Johns Hopkins University), Nelson K Sewankambo (0000-0001-9362-053X, MRC Epidemiology Unit), David Serwadda (0000-0001-6532-6587, Makerere University), Xian-Bin Li (0000-0002-6567-6349, Johns Hopkins University), Xianbin Li (0000-0002-9196-7027), Oliver Laeyendecker (0000-0002-6429-4760, Johns Hopkins University), Noah Kiwanuka (0000-0003-2471-9290, Rakai Health Sciences Program), Godfrey Kigozi (0009-0008-9142-6870, Rakai Health Sciences Program), Mohammed Kiddugavu (Rakai Health Sciences Program), Thomas Lutalo (Rakai Health Sciences Program), Fred Nalugoda (0000-0001-6119-9293, Rakai Health Sciences Program), Fred Wabwire‐mangen (Makerere University), Mary P Meehan (Columbia University), Thomas C Quinn (0000-0002-0404-1315, National Institutes of Health)
Year2005
Volume191
Issue9
Pages1403-1409
Publication date2005-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueThe Journal of Infectious Diseases (JOURNAL)
Journal identifiersISSN: 0022-1899 • E-ISSN: 1537-6613
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1086/429411
PMID15809897
OpenAlexW2160226661
LanguageEN
Citations received106
References cited6

BACKGROUND: We estimated rates of human immunodeficiency virus (HIV)-1 transmission per coital act in HIV-discordant couples by stage of infection in the index partner. METHODS: We retrospectively identified 235 monogamous, HIV-discordant couples in a Ugandan population-based cohort. HIV transmission within pairs was confirmed by sequence analysis. Rates of transmission per coital act were estimated by the index partner's stage of infection (recent seroconversion or prevalent or late-stage infection). The adjusted rate ratio of transmission per coital act was estimated by multivariate Poisson regression. RESULTS: The average rate of HIV transmission was 0.0082/coital act (95% confidence interval [CI], 0.0039-0.0150) within approximately 2.5 months after seroconversion of the index partner; 0.0015/coital act within 6-15 months after seroconversion of the index partner (95% CI, 0.0002-0.0055); 0.0007/coital act (95% CI, 0.0005-0.0010) among HIV-prevalent index partners; and 0.0028/coital act (95% CI, 0.0015-0.0041) 6-25 months before the death of the index partner. In adjusted models, early- and late-stage infection, higher HIV load, genital ulcer disease, and younger age of the index partner were significantly associated with higher rates of transmission. CONCLUSIONS: The rate of HIV transmission per coital act was highest during early-stage infection. This has implications for HIV prevention and for projecting the effects of antiretroviral treatment on HIV transmission.

Cohort · Confidence interval · Disease · Environmental health · Human immunodeficiency virus (HIV) · Index case · Poisson regression · Population · Seroconversion · Transmission (telecommunications) · Adolescent Sexual and Reproductive Health · Demography · HIV Research and Treatment · HIV/AIDS Research and Interventions · Immunology · Internal Medicine · Medicine · Virology