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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda
Journal of Infectious Diseases, Volume 191, No. 9, Year 2005
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Description
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 ∼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. © 2005 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Wawer, Maria J.
United States, New York
Mailman School of Public Health
Gray, Ronald H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Sewankambo, Nelson K.
Belgium, Beerse
Faculty of Medicine
Serwadda, David Musoke
Uganda, Kampala
Makerere University
Li, Xianbin
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Laeyendecker, Oliver B.
United States, Baltimore
Johns Hopkins Medical Institutions
Kiwanuka, Noah
Uganda, Entebbe
Uganda Virus Research Institute
Kigozi, Godfrey G.
Uganda, Entebbe
Uganda Virus Research Institute
Kiddugavu, Mohammed G.
Uganda, Entebbe
Uganda Virus Research Institute
Lutalo, Tom
Uganda, Entebbe
Uganda Virus Research Institute
Nalugoda, Fred Kakaire
Uganda, Entebbe
Uganda Virus Research Institute
Wabwire-Mangen, Fred
Uganda, Kampala
Makerere University
Meehan, Mary P.
United States, New York
Mailman School of Public Health
Quinn, Thomas Charles
United States, Baltimore
Johns Hopkins Medical Institutions
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Statistics
Citations: 1,391
Authors: 14
Affiliations: 7
Identifiers
Doi:
10.1086/429411
ISSN:
00221899
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Uganda