Abstract

PIP: The European Study Group's findings on Heterosexual Transmission of HIV, is criticized for methodological reasons. A question is raised about how the interaction between the index patient's disease and sex-related efficacy of transmission of HIV is derived. Data need to be made available on the HIV status of the contact at recruitment, the sex of the contact, the number of months of HIV-exposed sexual contact when the index patient had stage 1 disease, the number of months of HIV-exposed sexual contact when the patient had stage 2 disease, and so on. Another question pertains to prospective and past contact for those testing HIV positive and those testing HIV negative who later showed positive results. It is suggested that an improved strategy would be to consider as separate contacts those who where HIV positive at recruitment and those who had seroconversion later. Thus, crude rates of seroconversion can be obtained by a comparison between HIV-exposed sexual contact of female index patients and of male index patients; i.e., 3 seroconversions of females among 135 male contacts, or 2.2/100 HIV- exposed male sexual contacts; and 7 male seroconversions among 313 female contacts, or 2.2/100 HIV-exposed female sexual contacts. The stage of disease is crucial, and monthly exposure rates are pertinent. The data reported were insufficient to address these concerns: 159 male female index patients infected with HIV, of which 16 were HIV positive at recruitment and 3 seroconverted after recruitment; and 404 female contacts of 400 male index patents infected with HIV, of which 75 were seropositive at recruitment and 7 seroconverted subsequently.