Limitations in characterization of heterosexual HIV transmission risk: commentary on the models of Downs and De Vincenzi

Article Abstract:

A 1996 study attempting to use mathematical models to determine the risk of heterosexual HIV transmission appeared to be limited by the incomplete nature of the data it used. The data were from interviews with couples in which one or both partners were HIV infected. Risk was calculated using the numbers of unprotected sexual contacts that were reported by study participants. Other factors, however, may increase the risk of HIV transmission. Such factors include the presence of other sexually transmitted diseases, the lack of circumcision, or the stage of the person's HIV infection. The study concluded that a parametric mathematical model assuming a constant risk of infection for each contact is inadequate. Reliance on only the HIV status of study participants and the interviews about their sexual behavior may have led to the failure of this model. The most effective way to determine HIV transmission risks may involve interventional techniques that modify other risk factors while data is being collected.

Editorial, Evaluation, Epidemiological research, Cross sectional studies

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Probability of heterosexual transmission of HIV: relationship to the number of unprotected sexual contacts

Article Abstract:

The risk of heterosexual transmission of HIV does not appear to be based on a constant risk of infection from each sexual contact. Researchers analyzed data from interviews with 525 heterosexual couples in which one or both partners were HIV infected. The study participants, who were in nine European countries, reported numbers of unprotected sexual contacts that were used to calculate the risk of HIV transmission. A parametric mathematical model in which HIV infectivity was assumed to be constant for each contact appeared to underestimate the HIV transmission risk at low numbers of contacts and overestimate the risk at high numbers of contacts. Variability in HIV infectivity over time may result from such factors as the presence of other sexually transmitted diseases or the stage of the partner's HIV infection. The male-to-female HIV transmission risk appeared to be greater than the female-to-male transmission risk, although this difference was not shown to be significant using the parametric model.

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Heterosexual transmission of human immunodeficiency virus: variability of infectivity throughout the course of infection

Article Abstract:

Heterosexual transmission of the human immunodeficiency virus may occur primarily during certain phases of the infection. Researchers estimated the periods of disease transmission in 359 men and 140 women with HIV. According to a probabilistic model, infectivity from men to women using penile-anal sex was higher in the early and advanced stages of infection than in the lengthier intermediate period. No significant effect was found during female to male transmission and penile-vaginal contacts.

Models, HIV infection, HIV infections, HIV seropositivity, HIV positive

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