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Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda

The probability of HIV-1 transmission per coital act in representative African populations is unknown. We aimed to calculate this probability overall, and to estimate how it is affected by various factors thought to influence infectivity. 174 monogamous couples, in which one partner was HIV-1 positi... Full description

Journal Title: The Lancet (British edition) 2001, Vol.357 (9263), p.1149-1153
Main Author: Gray, Ronald H
Other Authors: Wawer, Maria J , Brookmeyer, Ron , Sewankambo, Nelson K , Serwadda, David , Wabwire-Mangen, Fred , Lutalo, Tom , Li, Xianbin , vanCott, Thomas , Quinn, Thomas C
Format: Electronic Article Electronic Article
Language: English
Subjects:
HIV
Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
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recordid: cdi_proquest_miscellaneous_70802011
title: Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda
format: Article
creator:
  • Gray, Ronald H
  • Wawer, Maria J
  • Brookmeyer, Ron
  • Sewankambo, Nelson K
  • Serwadda, David
  • Wabwire-Mangen, Fred
  • Lutalo, Tom
  • Li, Xianbin
  • vanCott, Thomas
  • Quinn, Thomas C
subjects:
  • Abridged Index Medicus
  • Adolescent
  • Adult
  • Biological and medical sciences
  • Coitus
  • Couples
  • Disease Transmission, Infectious
  • Female
  • HIV
  • HIV infection
  • HIV Infections - epidemiology
  • HIV Infections - transmission
  • HIV Seropositivity
  • HIV-1 - immunology
  • Human immunodeficiency virus
  • Human viral diseases
  • Humans
  • Infection
  • Infectious diseases
  • Male
  • Medical sciences
  • Middle Aged
  • Probability
  • Regression Analysis
  • Risk factors
  • Sexuality
  • Uganda - epidemiology
  • Viral diseases
  • Viral diseases of the lymphoid tissue and the blood. Aids
  • Viral Load
  • Viremia
ispartof: The Lancet (British edition), 2001, Vol.357 (9263), p.1149-1153
description: The probability of HIV-1 transmission per coital act in representative African populations is unknown. We aimed to calculate this probability overall, and to estimate how it is affected by various factors thought to influence infectivity. 174 monogamous couples, in which one partner was HIV-1 positive, were retrospectively identified from a population cohort in Rakai, Uganda. Frequency of intercourse and reliability of reporting within couples was assessed prospectively. HIV-1 seroconversion was determined in the uninfected partners, and HIV-1 viral load was measured in the infected partners. Adjusted rate ratios of transmission per coital act were estimated by Poisson regression. Probabilities of transmission per act were estimated by log-log binomial regression for quartiles of age and HIV-1 viral load, and for symptoms or diagnoses of sexually transmitted diseases (STDs) in the HIV-1-infected partners. The mean frequency of intercourse was 8·9 per month, which declined with age and HIV-1 viral load. Members of couples reported similar frequencies of intercourse. The overall unadjusted probability of HIV-1 transmission per coital act was 0·0011 (95% CI 0·0008–0·0015). Transmission probabilities increased from 0·0001 per act at viral loads of less than 1700 copies/mL to 0·0023 per act at 38 500 copies/mL or more (p=0·002), and were 0·0041 with genital ulceration versus 0·0011 without (p=0·02). Transmission probabilities per act did not differ significantly by HIV-1 subtypes A and D, sex, STDs, or symptoms of discharge or dysuria in the HIV-1-positive partner. Higher viral load and genital ulceration are the main determinants of HIV-1 transmission per coital act in this Ugandan population.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleProbability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda
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creatorGray, Ronald H ; Wawer, Maria J ; Brookmeyer, Ron ; Sewankambo, Nelson K ; Serwadda, David ; Wabwire-Mangen, Fred ; Lutalo, Tom ; Li, Xianbin ; vanCott, Thomas ; Quinn, Thomas C
creatorcontribGray, Ronald H ; Wawer, Maria J ; Brookmeyer, Ron ; Sewankambo, Nelson K ; Serwadda, David ; Wabwire-Mangen, Fred ; Lutalo, Tom ; Li, Xianbin ; vanCott, Thomas ; Quinn, Thomas C ; the Rakai Project Team ; Rakai Project Team
descriptionThe probability of HIV-1 transmission per coital act in representative African populations is unknown. We aimed to calculate this probability overall, and to estimate how it is affected by various factors thought to influence infectivity. 174 monogamous couples, in which one partner was HIV-1 positive, were retrospectively identified from a population cohort in Rakai, Uganda. Frequency of intercourse and reliability of reporting within couples was assessed prospectively. HIV-1 seroconversion was determined in the uninfected partners, and HIV-1 viral load was measured in the infected partners. Adjusted rate ratios of transmission per coital act were estimated by Poisson regression. Probabilities of transmission per act were estimated by log-log binomial regression for quartiles of age and HIV-1 viral load, and for symptoms or diagnoses of sexually transmitted diseases (STDs) in the HIV-1-infected partners. The mean frequency of intercourse was 8·9 per month, which declined with age and HIV-1 viral load. Members of couples reported similar frequencies of intercourse. The overall unadjusted probability of HIV-1 transmission per coital act was 0·0011 (95% CI 0·0008–0·0015). Transmission probabilities increased from 0·0001 per act at viral loads of less than 1700 copies/mL to 0·0023 per act at 38 500 copies/mL or more (p=0·002), and were 0·0041 with genital ulceration versus 0·0011 without (p=0·02). Transmission probabilities per act did not differ significantly by HIV-1 subtypes A and D, sex, STDs, or symptoms of discharge or dysuria in the HIV-1-positive partner. Higher viral load and genital ulceration are the main determinants of HIV-1 transmission per coital act in this Ugandan population.
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subjectAbridged Index Medicus ; Adolescent ; Adult ; Biological and medical sciences ; Coitus ; Couples ; Disease Transmission, Infectious ; Female ; HIV ; HIV infection ; HIV Infections - epidemiology ; HIV Infections - transmission ; HIV Seropositivity ; HIV-1 - immunology ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infection ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Probability ; Regression Analysis ; Risk factors ; Sexuality ; Uganda - epidemiology ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load ; Viremia
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descriptionThe probability of HIV-1 transmission per coital act in representative African populations is unknown. We aimed to calculate this probability overall, and to estimate how it is affected by various factors thought to influence infectivity. 174 monogamous couples, in which one partner was HIV-1 positive, were retrospectively identified from a population cohort in Rakai, Uganda. Frequency of intercourse and reliability of reporting within couples was assessed prospectively. HIV-1 seroconversion was determined in the uninfected partners, and HIV-1 viral load was measured in the infected partners. Adjusted rate ratios of transmission per coital act were estimated by Poisson regression. Probabilities of transmission per act were estimated by log-log binomial regression for quartiles of age and HIV-1 viral load, and for symptoms or diagnoses of sexually transmitted diseases (STDs) in the HIV-1-infected partners. The mean frequency of intercourse was 8·9 per month, which declined with age and HIV-1 viral load. Members of couples reported similar frequencies of intercourse. The overall unadjusted probability of HIV-1 transmission per coital act was 0·0011 (95% CI 0·0008–0·0015). Transmission probabilities increased from 0·0001 per act at viral loads of less than 1700 copies/mL to 0·0023 per act at 38 500 copies/mL or more (p=0·002), and were 0·0041 with genital ulceration versus 0·0011 without (p=0·02). Transmission probabilities per act did not differ significantly by HIV-1 subtypes A and D, sex, STDs, or symptoms of discharge or dysuria in the HIV-1-positive partner. Higher viral load and genital ulceration are the main determinants of HIV-1 transmission per coital act in this Ugandan population.
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30Viremia
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titleProbability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda
authorGray, Ronald H ; Wawer, Maria J ; Brookmeyer, Ron ; Sewankambo, Nelson K ; Serwadda, David ; Wabwire-Mangen, Fred ; Lutalo, Tom ; Li, Xianbin ; vanCott, Thomas ; Quinn, Thomas C
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10HIV Infections - epidemiology
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12HIV Seropositivity
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23Regression Analysis
24Risk factors
25Sexuality
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abstractThe probability of HIV-1 transmission per coital act in representative African populations is unknown. We aimed to calculate this probability overall, and to estimate how it is affected by various factors thought to influence infectivity. 174 monogamous couples, in which one partner was HIV-1 positive, were retrospectively identified from a population cohort in Rakai, Uganda. Frequency of intercourse and reliability of reporting within couples was assessed prospectively. HIV-1 seroconversion was determined in the uninfected partners, and HIV-1 viral load was measured in the infected partners. Adjusted rate ratios of transmission per coital act were estimated by Poisson regression. Probabilities of transmission per act were estimated by log-log binomial regression for quartiles of age and HIV-1 viral load, and for symptoms or diagnoses of sexually transmitted diseases (STDs) in the HIV-1-infected partners. The mean frequency of intercourse was 8·9 per month, which declined with age and HIV-1 viral load. Members of couples reported similar frequencies of intercourse. The overall unadjusted probability of HIV-1 transmission per coital act was 0·0011 (95% CI 0·0008–0·0015). Transmission probabilities increased from 0·0001 per act at viral loads of less than 1700 copies/mL to 0·0023 per act at 38 500 copies/mL or more (p=0·002), and were 0·0041 with genital ulceration versus 0·0011 without (p=0·02). Transmission probabilities per act did not differ significantly by HIV-1 subtypes A and D, sex, STDs, or symptoms of discharge or dysuria in the HIV-1-positive partner. Higher viral load and genital ulceration are the main determinants of HIV-1 transmission per coital act in this Ugandan population.
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