Sex and AIDS – From the Medical Literature

Sex is not the major factor in creating Aids, according to 25 years of study in the major medical literature, but this information is actively suppressed by the medical establishment and major media that reports and spins its research. The idea that Aids is sexual is actively promoted, along lines of color and sexual orientation, in line with historical Eugenic thought and in line with scientific racism.

From the standard medical literature, cited at ARAS.ab.ca:

Notes by David Crowe.

Transmission in Prostitutes

Prostitutes should be at grave risk of HIV/AIDS infection, but there is some evidence that they are not, unless they abuse drugs (which many do). They often have unprotected sex with many men of unknown HIV status. In places like Africa with a high fraction of men HIV-positive, this must mean that they are having unprotected sex with tens or hundreds of HIV-positive men, yet many of them are not becoming HIV-positive.

“A subset of 140 women out of a total of over 2000 participants from the Pumwani Sex Worker cohort have been identified to be relatively resistant to HIV-1 infection. Previously described resistance mechanisms, such as ?-32-CCR5 polymorphisms, have been discounted in this population as their cells are readily infected in vitro and this genotype has not been detected in this group…39 women were included in the study…HIV-1-resistant (HIV-R [HIV-negative and under study for more than 3 years], n=10 [i.e. 10 women in this group]), HIV-1-negative (HIV-N [HIV negative and under study for less than 3 years], n=10), HIV-1-positive (infected) sex workers (HIV-P, n=10), and HIV-1-uninfected women from the Mother to Child Transmission cohort (MCH, n=9) which were included as an additional low risk of infection, HIV-1-uninfected control group. All of the women from the sex worker cohort were actively engaged in sex work at the time of sample collection…The average age for the HIV-R group was 40.6±5.2 years; HIV-P group 36.5±5.3 years; HIV-N group 30±6.83 years; and MCH 39±4.5 years…Eight proteins were overexpressed and nine were underexpressed in the HIV-R group…[There is no mention of disease in the HIV-positive women. This therefore is evidence that HIV seropositivity is not associated with sexual transmission, and that HIV seropositivity is not proof that disease will follow]”

  • Burgener A et al. Identification of Differentially Expressed Proteins in the Cervical Mucosa of HIV-1-Resistant Sex Workers. J Proteome Res. 2008 Aug 16

“Data were from a prospective cohort study of 1206 HIV-1 seronegative sex workers from Mombasa, Kenya who were followed monthly…233 women acquired HIV-1 (8.7/100 person-years)…In multivariate analysis, including adjustment for HSV-2, HIV-1 acquisition was associated with use of oral contraceptive pills [adjusted hazard ratio (HR), 1.46] and depot medroxyprogesterone acetate [aka DMPA or Depo-Provera, a contraceptive providing 3 months protection with each injection] [This could indicate that these chemicals are increasing the risk of false positive HIV tests]”

  • Baeten JM et al. Hormonal contraceptive use, herpes simplex virus infection, and risk of HIV-1 acquisition among Kenyan women. AIDS. 2007 Aug 20;21(13):1771-1777.

“Despite an association between bacterial STIs and acquisition of HIV-1 infection, the addition of monthly azithromycin prophylaxis to established HIV-1 risk reduction strategies [among Kenyan prostitutes] substantially reduced the incidence of STIs but did not reduce the incidence of HIV-1. Prevalent HSV-2 infection may have been an important cofactor in acquisition of HIV-1.”

  • Kaul R et al. Monthly antibiotic chemoprophylaxis and incidence of sexually transmitted infections and HIV-1 infection in Kenyan sex workers: a randomized controlled trial. JAMA. 2004 Jun 2;291(21):2555-62.

“In this study, the authors…recorded information on prostitute women identified by police and health department surveillance in Colorado Springs, Colorado, from 1967 to 1999…They identified 117 definite or probable deaths [about double the rate that would be expected compared to the general population]…Violence and drug use were the predominant causes of death, both during periods of prostitution and during the whole observation period…Deaths from acquired immunodeficiency syndrome occurred exclusively among prostitutes who admitted to injecting drug use or were inferred to have a history of it.”

  • Potterat JJ et al. Mortality in a Long-term Open Cohort of Prostitute Women. Am J Epidemiol. 2004 Apr 15;159(8):778-85.

“The maintenance of seronegativity despite exposure to HIV has been observed in sexual partners of HIV infected persons [7 references given], infants born to HIV-infected mothers [3 references], commercial sex workers [4 references] and health care workers occupationally exposed to HIV-contaminated body fluids [2 references]”

  • Makedonas G et al. HIV-specific CD8 T-cell activity in uninfected injection drug users is associated with maintenance of seronegativity. AIDS. 2002 Aug 16;16(12):1595-602.

“some sexual behaviour variables, such as prostitution, appeared to be significant predictors of HIV seropositivity only among men”

  • Bruneau J et al. Sex-specific determinants of HIV infection among injection drug users in Montreal. CMAJ. 2001 Mar 20;164(6):767-73.

“Female sex workers enrolled in the Pumwani Sex Worker Cohort in Nairobi, Kenya were the source of HIV-1-resistant and HIV-1- infected subjects for the studies described here…24 women who were classified as resistant to HIV_1 were available to participate in these studies. All were HIV-1 antibody negative by both enzyme immunoassay and immunoblot.

Negative serology on each individual was performed 8-56 times over 4-10 years. All women were HIV-1 PCR negative on specimens obtained simultaneously with the studies reported here. None of the HIV-1-resistant women participating in the present study have subsequently seroconverted to HIV-1 in an additional 24 months of follow up, despite continued exposure to HIV-1 through sex work…These women have intense exposure to HIV-1 through their occupation and, although condom use is frequent (> 80% of sexual encounters), their risk of acquiring HIV-1 infection is enormous. Despite this intense exposure of up to 500 unprotected sexual exposures to HIV-1-infected clients, a small number (13% of initially HIV-1 seronegative women) remain HIV-1 uninfected for prolonged periods (up to 13 years).”

  • Fowke KR et al. HIV-1-specific cellular immune responses among HIV-1-resistant sex workers. Immunol Cell Biol. 2000 Dec;78(6):586-95.

“26 HIV-1-resistant sex workers and 16 HIV-1-infected sex workers were enrolled…A well-defined CD8+ lymphocyte [white blood cell] population was present in all samples…No differences were noted…according to HIV-1 infections status…No association was found between cervical or systemic [i.e. blood] responses [on an HIV-1-specific ELISPOT antibody test] and total CD4+ or CD8+ lymphocyte counts in either HIV-1-resistant or HIV-1-infected subjects. Neither systemic nor mucosal HIV-1-specific IFN-gamma responses were associated with sexual risk behaviors as reported by study subjects at the time of study enrollment, including number of clients per day, duration of sex work, or frequency of condom use [women with sexually transmitted infections were excluded from this study]”

  • Kaul R et al. HIV-1-specific mucosal CD8+ lymphocyte responses in the cervix of HIV-1-resistant prostitutes in Nairobi. J Immunol. 2000 Feb 1;164(3):1602-11.

“No correlation was found between the presence of HIV-1-specific IgA [antibodies] in the genital tract of resistant sex workers and immunologic parameters (CD4+ or CD8+ T-lymphocyte counts), behavioural factors (duration of prostitution, frequency of condom use, number of clients per day, or type of contraceptive use), or demographic factors (age).”

  • Kaul R et al. HIV-1-specific mucosal IgA in a cohort of HIV-1-resistant Kenyan sex workers. AIDS. 1999 Jan 14;13(1):23-9.

“The study participants were selected from women in the Pumwani sex-worker cohort in Nairobi, Kenya, which was established in a collaboration between the Universities of Nairobi and Manitoba in 1985, as described. The ‘resistant’ women are defined as those remaining seronegative for >3 yr of follow-up. They remain healthy and persistently seronegative for HIV-1 (ELISA for HIV-1/2/0, Murex); repeated testing for HIV-1 proviral DNA by PCR (using specific primer sets for HIV-1 env , nef , and pol ) has always been negative…The extent of exposure, daily over many years, and the diversity of potential infecting strains of HIV are certainly the greatest reported anywhere in the world…The CTL [cytotoxic lymphocyte] studies reported here used a very sensitive technique for eliciting memory peptide-specific CTL, which generated HIV-specific CTL from just under half the women studied; however, this is likely to be an underestimate [the researchers may be biased towards this assumption, as otherwise their investigations into CTL types may be seen as a dead end].”

  • Rowland-Jones SL et al. Cytotoxic T cell responses to multiple conserved HIV epitopes in HIV-resistant prostitutes in Nairobi. J Clin Invest. 1998 Nov 1;102(9):1758-65.

“Some sex workers and homosexual men remain uninfected despite repeatedly having unprotected sexual intercourse with HIV-infected partners”

  • Royce RA et al. Sexual transmission of HIV. N Engl J Med. 1997 Apr 10;336(15):1072-8.

“[This study involved] a group of repeatedly exposed but persistently seronegative female prostitutes in The Gambia, West Africa…The seronegative women in this study have worked as prostitutes for more than five years, use condoms infrequently with clients and only rarely with their regular partners, and have a high incidence of other sexually transmitted diseases”

  • Rowland-Jones S et al. HIV-specific cytotoxic T-cells in HIV-exposed but uninfected Gambian women. Nat Med. 1995 Jan;1(1):59-64.

“Human immunodeficiency virus (HIV) prevalence was studied in an unselected group of 216 female and transsexual prostitutes…All 128 females who did not admit to drug abuse were seronegative; 2 of the 52 females (3.8%) who admitted to intravenous drug abuse were seropositive.”

  • Modan B et al. Prevalence of HIV antibodies in transsexual and female prostitutes. Am J Public Health. 1992 Apr;82(4):590-2.

“In 85% of these infected couples, only one member was HIV-1 seropositive despite repeated unprotected sex…A correlation between a recent history of having had sex with a prostitute and HIV-1 seropositivity could not be demonstrated in men who did not have a past history of GUD [genito-urinary disease]”

  • Ryder RW et al. Heterosexual transmission of HIV-1 among employees and their spouses at two large businesses in Zaire.. AIDS. 1990 Aug 4;4(8):725-32.

“In order to determine whether prostitutes operating outside of areas of high drug abuse have equally elevated rates of infection, 354 prostitutes were surveyed in Tijuana, Mexico…None of the 354 [blood] samples…was positive for HIV-1 or HIV-2…Condoms were used…for less than half of their sexual contacts. Only 4 female prostitutes (1%) admitted to ever having abused intravenous drugs. Infection with HIV was not found in this prostitute population despite the close proximity to neighboring San Diego, CA, which has a high incidence of diagnosed cases of AIDS, and to Los Angeles, which has a reported 4% prevalence of HIV infection in prostitutes.”

  • Hyams KC et al. HIV infection in a non-drug abusing prostitute population. Scand J Infect Dis. 1989;21(3):353-4.

“No client of a prostitute in London has been found to be positive for antibodies to HIV at the [Praed Street] clinic [as of September, 1988]”

  • Day S, Ward H, Harris JR. Prostitute women and public health. BMJ. 1988 Dec 17;297(6663):1585.

“HIV infection in non-drug using prostitutes tends to be low or absent, implying that sexual activity does not place them at high risk, while prostitutes who use intravenous drugs are far more likely to be infected with HIV…The prevalence of HIV antibodies among prostitutes ranges between zero and 65 per cent, with the single most important risk factor in the US being intravenous drug use. For example, a large multicenter collaborative study found that of 62 women who were HIV-seropositive, 76 per cent had injected drugs. The highest rate of seropositivity for all centers occurred in New Jersey, which is an area of high drug use; here the rate of seropositivity among 56 women prostitutes was 57 per cent. Another cross-sectional study found that among 535 practicing prostitutes in Nevada, 7 per cent of whom admitted to intravenous drug use, none were positive. In contrast, 370 incarcerated prostitutes, all of whom had used drugs intravenously, had a seropositive rate of 6.2 per cent. Other prostitute studies tend to be small but similarly emphasize the central role of drug use as a major risk factor: in New York City, 50 per cent of 12 drug users were positive, compared with 7 per cent of 65 nonusers; in Italy, 59 per cent of 22 drug users were positive, whereas non of the nonusers were. None of the 50 prostitutes tested in London, 56 in Paris, or 399 in Nuremberg were seropositive.”

  • Rosenberg MJ, Weiner JM. Prostitutes and AIDS: a health department priority?. Am J Public Health. 1988 Apr;78(4):418-23.

Resistance to Transmission

Some people seem remarkably resistant to HIV infection, almost like HIV wasn’t transmissible at all!

“It was in September that year [1989] that Joe Muriuki, a clerk with the Nairobi City Council, went for a HIV test because of some skin infection that refused to go and persistent night sweating that left him cold. But the news that awaited him was numbing. He was HIV positive. The worst was yet to come. Doctors predicted that it would be a matter of time before his wife, then three-weeks pregnant, also tested positive. In the light of those developments, they suggested that the Muriukis abort the foetus. Muriuki then started preparing for his death by packing his belongings to return to his rural home…“Those days, testing HIV positive was equated to a death sentence. It was a matter a months and…” Muriuki gestures helplessly. “You would be gone.”…Eighteen years on, Muriuki is convinced that one can live as healthy as others and he is a living testament of that resolve…Jane[his wife] tested negative but a prejudiced society found it hard to believe…An ever smiling Jane is the mother of three boys. Her last born, Eric Munyiri, the boy that doctors wanted terminated, was one of the top performers in the 2003 Kenya Certificate of Primary Education. “I had sought advice from a number of doctors who all felt that there was no need for me to give birth to a baby who would soon die,” Jane recalls.” But I rejected their advice and left everything to God.”…Jane, who was only 26 when Muriuki went public says, “Initially it was strange for me to be negative. I did not understand and thought maybe it was God’s will and therefore I decided to fully support my husband to overcome the social stigma or any unfairness he would encounter.”…After 18 years, Muriuki is not on ARVs, goes for periodic medical tests and generally keeps healthy by eating well. It’s called the spirit of life.

  • Kimani P, Wachira M. Aids patient lives on, 17 years later. The Nation (Kenya). 2007 Jan 6

“Repeated exposure to human immunodeficiency virus (HIV) does not always result in seroconversion…Nineteen subjects at risk for HIV infection [including 14 in ‘stable relationships with HIV-infected sex partners] were CCR-5 genotyped and screened for virus-specific memory cytotoxic T lymphocytes (CTL). None had the delta-32CCR-5/delta-32CCR-5 genotype associated with HIV resistance. HIV-specific CTL were detected in 7 (41.1%) of 17 exposed uninfected subjects versus 0 of 14 seronegative subjects with no HIV risk factors.”

  • Bernard NF et al. Human immunodeficiency virus (HIV)-specific cytotoxic T lymphocyte activity in HIV-exposed seronegative persons. J Infect Dis. 1999 Mar;179(3):538-47.

“To analyze whether HIV-specific mucosal immunity can coexist with HIV-specific systemic ccellular immunity in HIV-sexually exposed and seronegative individuals, we analyzed perhipheral blood mononuclear cells (PBMCs), urine, and cervical swabs in 16 heterosexual couples discordant for HIV status in serum [one HIV+, the other HIV-] and reporting multiple episodes of unprotected sex…HIV plasma viral load was undetectable in all the seronegative individuals. Length of exposure, time since last exposure, and CD4 counts in the HIV-seropositive partners, and CD4 counts [did not correlate with] the detection of HIV-specific immune responses in the seronegative exposed partners…Exposure to HIV does not inevitably result in infection.”

  • Mazzoli S et al. HIV-specific mucosal and cellular immunity in HIV-seronegative partners of HIV-seropositive individuals. Nat Med. 1997 Nov;3(11):1250-7.

“A highly selected cohort of 24 HIV-1 seronegative subjects with histories of multiple high-risk sexual exposures to HIV-1 were studied. The cohort [included 7] homosexual men who reported sex with multiple HIV-1-infected partners, [5] homosexual men with predominantly a single HIV-1-infected partner, and [13] heterosexual individuals reporting sex predominantly with a single HIV-1-infected partner…Among the individuals reporting exposure to predominantly a single HIV-infected partner, most were in long-term relationships involving unprotected sexual intercourse over many years during which time several partners succumbed to AIDS. All subjects were HIV-1 negative by commercially available enzyme-linked immunsorbent assay (ELISA) tests and by diagnostic polymerase chain reaction (PCR)”

  • Paxton WA et al. Relative resistance to HIV-1 infection of CD4 lymphocytes from persons who remain uninfected despite multiple high-risk sexual exposure. Nat Med. 1996 Apr;2(4):412-7.

“[This study involved] a group of repeatedly exposed but persistently seronegative female prostitutes in The Gambia, West Africa…The seronegative women in this study have worked as prostitutes for more than five years, use condoms infrequently with clients and only rarely with their regular partners, and have a high incidence of other sexually transmitted diseases”

  • Rowland-Jones S et al. HIV-specific cytotoxic T-cells in HIV-exposed but uninfected Gambian women. Nat Med. 1995 Jan;1(1):59-64.

“An important advanced in the rational design of a prophylactic vaccine against HIV would be identification of people who have been exposed to HIV and generated an immune response, but not become persistently infected. A characteristic feature of the immune response to HIV is presence in healthy seropositive subjects of vigorous HIV-specific cytotoxic [cell killing] T-lymphocyte (CTL) activity…We describe the finding of HIV-specific CTL activity in a child born to an HIV-infected mother [and HIV antibody-positive at birth]; all standard markers of HIV infection in the child were negative by the age of 13 months [including antibody tests, antigen tests, PCR RNA and DNA]…if the child has never been infected it is difficult to explain the finding of HIV-specific CTL activity, which normally requires actively replicating virus for stimulation.”

  • Rowland-Jones SL et al. HIV-specific cytotoxic T-cell activity in an HIV-exposed but uninfected infant. Lancet. 1993 Apr 3;341(8849):860-1.

Heterosexual Transmission

We have been told for years that heterosexuals in Western countries are at great risk of acquiring HIV/AIDS. But the promised epidemic has never occurred. Even in groups that should be at risk, such as the wives of hemophiliacs, sexual transmission appears to be very rare.

“Mandy Webb, 42, was horrified when she was diagnosed HIV positive, especially as she hadn’t had sex for over a decade…Mandy first noticed something was wrong back in 1990, when her son, Ben, was two. She says: ‘I kept getting bruises…”. She went to her GP for blood tests and the results showed Mandy’s platelets were dangerously low…she was put on steroids to help her blood clot. However the drugs made her weight balloon. In 1991, doctors offered Mandy another option – to have her spleen removed and be given injections of factor Vlll (a blood protein) to help her blood to clot. Mandy went ahead but after surgery she kept getting chest infections. And, over the years, her health deteriorated. Suffering from diarrhoea, Mandy’s weight plummeted to under eight stone and her periods stopped. She developed painful mouth ulcers and night sweats…Her GP diagnosed irritable bowel syndrome and prescribed anti-depressants for stress… which Mandy didn’t take. “I tried to make the best of things,” she explains, “but it got worse and worse…”

Then, six years ago, Mandy had problems walking and became disorientated. Her mum took her to another GP, who suggested an HIV test. A stunned Mandy replied: “Why? I haven’t had sex for 14 years!” Ben had been the product of a drunken one-night stand when Mandy was a 21-year-old drama student in Portsmouth. Doctors admitted Mandy to hospital and she was found to be in the third stage of HIV infection – the final one before it progresses to full-blown Aids. As doctors treated her with antibiotics and introduced anti-Aids medications, Mandy slowly began to recover…“No one knew how I’d caught HIV. I believe it was either from unprotected sex in my youth or from contaminated factor Vlll.”… [however] by 1991, when Mandy started having factor-Vlll treatment, blood products were screened. She was told it was unlikely to be the cause…Dependent on her mum to care for her, Mandy left hospital in a wheelchair.

After three months, she began to recover and walk again. Today, she has high cholesterol [associated with protease inhibitors] and continuing problems with walking and balance. No one knows yet what permanent damage HIV has had on her [and nobody wants to know what damage the drugs have done]…“It’s World Aids day on Monday and I’m speaking out to try to dispel the myths about HIV and reduce the stigma so that people aren’t afraid to go and get tested…” [despite no good explanation for how she became HIV+, although an immune reaction to Factor VIII causing a false positive HIV test isn’t a bad guess]”

  • Gregory J. I hadn’t had sex for over 14 years how could I be HIV positive?. The Mirror. 2008 Nov 27

“Heterosexual transmission continues to drive the epidemic among sex workers, their clients, and their clients’ partners. In addition, prisoners, injecting drug users, as well as men who have sex with men, may also engage in heterosexual relationships. In sub-Saharan Africa almost 60% of adults living with HIV were women, 48% in the Caribbean. [Yet, worldwide, women are always less promiscuous than men, so this consistent pattern should be impossible with a heterosexually transmitted epidemic]”

  • De Cock KM, De Lay P. Correction to AIDS story in The Independent, 8 June 2008. UNAIDS. 2008 Jun 11 http://data.unaids.org/pub/PressStatement/2008/20080611_notetomedia_en.pdf

“ In 1997, UNAIDS chief Peter Piot gloomily foretold that “AIDS will cut through Asian populations like a hot knife through cold butter.” Aside from a few explosive heterosexual epidemics within large commercial sex networks in Thailand, Myanmar, Cambodia and several states in India in the late 1980s to early 1990s, Dr. Piot’s dire and colorful prediction never occurred.”

  • Chin J. Myths behind AIDS might lead to billions in misspending. The China Post. 2008 May 18 http://www.chinapost.com.tw/commentary/the%20china%20post/special%20to%20the%20china%20post/2008/05/18/156965/Myths-behind.htm

“An HIV-positive man who didn’t tell his girlfriend he had the condition was sentenced to 12 years in prison Thursday…Neither [his girlfriend nor another sexual partner] contracted HIV despite their long-term relationship with Hunter, Jones said…Court documents said Hunter has hemophilia and got HIV through a blood transfusion when he was 7 years old. He attended the University of Arkansas, where he met at least one of the women.”

  • Wood R. Man Gets Prison Term For Exposing Woman To HIV. The Morning News (Arkansas). 2008 May 1 http://www.nwaonline.net/articles/2008/05/01/news/050208fzhunter.txt

“Of 18 525 Ugandans aged 15–59 years who had HIV serological testing, 1092 (5.9%) were HIV-infected…64% were female…100 (9%) of those who had ever had sex stated that they knew all their partners’ HIV status and 2% knew some of their partners’ HIV status…99% of HIV-infected persons had had sex and 77% were sexually active in the last year, including 86% of men and 72% of women…86% reported having had sex only with their spouses in the last year, including 75% of men and 96% of women…Of all married HIV-infected persons, 13% reported only one sexual partner in their life…Of last sex acts of HIV-infected persons, 83% were unprotected and 84% of these took place with married and cohabitating partners, 13% with steady partners and 3% with casual partners. Among those who had had sex, 67% reported never having used a condom”

  • Bunnell R et al. HIV transmission risk behavior among HIV-infected adults in Uganda: results of a nationally representative survey. AIDS. 2008 Mar 12;22(5):617-24.

“Sera were obtained from 2103 South African individuals (862 miners, 95 sex workers, 731 female and 415 male township residents; mean age 33.2 years). All sera were tested for antibodies to KSHV [Kaposi’s Sarcoma Herpes Virus, believed by some to be the cause of this skin cancer or cancer-like condition]…, HIV, gonococcus, herpes simplex virus type 2 (HSV-2), syphilis and chlamydia. Information on social, demographic and high-risk sexual behavior was linked to laboratory data…Overall KSHV and HIV prevalences were 47.5% and 40%, respectively…No significant difference in KSHV infection was observed among the residential groups. KSHV was not associated with any of the STI or any measures of sexual behavior.”

  • Malope BI et al. No evidence of sexual transmission of Kaposi’s sarcoma herpes virus in a heterosexual South African population. AIDS. 2008 Feb 19;22(4):519-26.

“During 5253 person-years at risk, 170 individuals [in an area of rural South Africa] became seropositive. The crude HIV incidence rate [new conversions to HIV seropositivity] per 100 person-years was 3.8 in women aged 15–49 years and 2.3 in men aged 15– 54 years.”

  • Bärnighausen T et al. High HIV incidence in a community with high HIV prevalence in rural South Africa: findings from a prospective population-based study. AIDS. 2008 Jan 2;22(1):139-44.

“we find that achieving the same equilibrium prevalence as MSM [men who have sex with men] requires heterosexual individuals to average 4.9 UVI [unprotected vaginal intercourse] partners annually, 2.7 times more partners than MSM [which could explain the characteristics of the AIDS epidemic in the US, but clearly not in Africa]”

  • Goodreau S, Golden MR. Biological and demographic causes of high HIV and STD prevalence in men who have sex with men. Sex Transm Inf. 2007 Sep 13 [online]

“In June 2006, a 77-year-old Japanese man with an acute asthma attack was admitted to our hospital in Yokohama, Japan. A pre-admission HIV screening test by enzyme immunoassay unexpectedly detected his HIV seropositivity…strong seroreactivity to HIV-2, but not to HIV-1 [and further tests confirmed this]…He had no history of engaging in high risk sexual contact and substance abuse in the past. Both his spouse (72 years old) and their son (34 years old) were HIV-negative. He, however, had a near-fetal[sic] motor accident in Senegal in June 1971…he received a large unit of blood from a number of volunteer Senegalian donors. He has never been transfused with blood products except on that occasion…After 8 days, he was discharged from hospital…His CD4 cell count was 827 cells/µL…He continues to be [a] long-term nonprogressor [Obviously his wife and him had unprotected sex after the accident, 36 years ago, but it did not result in transmission]”

  • Utsumi T et al. An HIV-2-infected Japanese man who was a long-term nonprogressor for 36 years. AIDS. 2007 Aug 20;21(13):1834-5.

“The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%.”

  • Poulin C et al. Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons. CMAJ. 2007 Jul 31;177(3):252-6.http://www.cmaj.ca/cgi/reprint/177/3/252

“Violence and rape are believed to fuel the HIV epidemic in countries affected by conflict. We compared HIV prevalence in populations directly affected by conflict with that in those not directly affected and in refugees versus the nearest surrounding host communities in sub-Saharan African countries…Seven countries affected by conflict (Democratic Republic of Congo, southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia, and Burundi) were chosen since HIV prevalence surveys within the past 5 years had been done and data, including original antenatal-care sentinel surveillance data, were available.

We did a systematic and comprehensive literature search using Medline and Embase. Only articles and reports that contained original data for prevalence of HIV infection were included…Of the 295 articles that met our search criteria, 88 had original prevalence data and 65 had data from the seven selected countries.

Data from these countries did not show an increase in prevalence of HIV infection during periods of conflict, irrespective of prevalence when conflict began. Prevalence in urban areas affected by conflict decreased in Burundi, Rwanda, and Uganda at similar rates to urban areas unaffected by conflict in their respective countries. Prevalence in conflict-affected rural areas remained low and fairly stable in these countries.

Of the 12 sets of refugee camps, nine had a lower prevalence of HIV infection[!], two a similar prevalence, and one a higher prevalence than their respective host communities. Despite wide-scale rape in many countries, there are no data to show that rape increased prevalence of HIV infection at the population level. [Note that rape being a violent crime should increase the transmission of a virus because of a greater likelihood of contact with blood due to violent penetration, beating of women and so on. The fact that this is not the case indicates that HIV is not behaving like a sexually transmitted virus]”

  • Spiegel PB et al. Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review. Lancet. 2007 Jun 30;369:2187-95.

“All analyses were limited to the 3993 women with complete data on the number of lifetime sexual partners and the corresponding ages of those partners…The (weighted) mean reported number of partners was 2.3. The estimated overall prevalence of HIV among sexually active women was 21.2%…Estimates of HIV prevalence ranged from 15.2% among women reporting one lifetime partner to 23.1% for two partners, 28.7% for three partners, and 28.5% among those with more than three partners…for the 3993 women included in the models above, the estimated mean (median) number of reported contacts per relationship was approximately 82…[making some assumptions results in the estimate] that the per-contact probability of HIV transmission are in the range of 1/50 to 1/16 contacts [compared to about 1/1000 estimated by Nancy Padian in 1997 in North America] [No other possible reasons for young black women reacting positive on HIV tests were considered in this study]

…we also found that for the 3993 women included in the models above, the estimated mean (median) number of reported contacts per relationship was approximately 82…[after making some assumptions] These estimates suggest that the per-contact probability of HIV transmission [is] in the range of 1/50 to 1/16 contacts…we also found that 4% of young women who reported never having had sex were infected with HIV, indicating the presence of reporting error in this study [or other reasons for young black women to test positive on HIV tests at such a high rate, a possibility not considered by this, or most other research]”

  • Pettifor AE et al. Highly efficient HIV transmission to young women in South Africa. AIDS. 2007 Apr 23;21(7):861-865.

“[Among 778 Ukrainian IV drug users]…With regard to sexual risk behaviors, those who were abstinent were more likely to be HIV positive than those who were sexually active. Those who had an HIV-positive sex partner, however, were twice as likely to be HIV positive themselves as those who did not have an HIV-positive partner or who did not know the status of their partner.”

  • Booth RE et al. Predictors of HIV sero-status among drug injectors at three Ukraine sites. AIDS. 2006 Nov 14;20(17):2217-23.

“Britain is funding a study into how tens of thousands of HIV-positive Kenyans have mysteriously not passed the virus to their husbands or wives…early surveys showed that up to 40% of people with HIV in the area had not passed the virus to their partners, despite regularly engaging in unprotected sex over long periods of marriage”

  • Britain funds study into mystery of the fishermen’s wives who never catch Aids. Daily Telegraph. 2005 Dec 14 http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2005/12/14/waids13.xml&sSheet=/health/2005/12/14/ixhmain.htm

“Abstinence and sexual fidelity have played virtually no role in the much-heralded decline of AIDS rates in the most closely studied region of Uganda”

  • Brown D. Uganda’s AIDS declines attributed to deaths. Washington Post. 2005 Feb 23;A2.

“Public health and political authorities have ascribed the apparent decline in Ugandan HIV or AIDS rates to increased rates of sexual abstinence or condom use. However, what appears to be special about Uganda is that in the middle to late 1980s there was a growing public awareness of health care risks. Given the lack of evidence for transmission of HIV to healthy persons by penile-vaginal intercourse, the improvement in injection safety is the best candidate for declining HIV and AIDS rates.”

  • Brody S. Declining HIV rates in Uganda: due to cleaner needles, not abstinence or condoms. Int J STD AIDS. 2004 Jul;15(7):440-1.

“At Kenyatta National Hospital VCT centre, an estimate 10% to 15% of the couples who get tested turn out to be discordant [one HIV+, one HIV-]…’the infected partner is not getting opportunistic infections despite having the virus for a long time’, says Dr. Moses Otsyula, an HIV expert…Their CD4 counts are not declining…And they have very low viral loads…out of 31 couples [recently] tested, 23 were discordant couples. Some of them have stayed in a sexual relationship with the infected partner for more than six years without the infected one passing the virus to the other. And when these discordant couples brought their children for testing, all of them were free of the virus…In the Kenya AIDS Vaccine Initiative case, commercial sex workers in Majengo slums were found to remain HIV negative even after having unprotected sex with infected men”

  • Okwemba A. Doctors ponder why some couples have mixed results. Horizon Magazine. 2003 Dec 18

“There is substantial dissonance between much of the epidemiologic evidence and the current orthodoxy that nearly all of the HIV burden in sub-Saharan Africa can be accounted for by heterosexual transmission and the sexual behaviour of Africans. The mounting toll of HIV infection in Africa is paralleled by a mounting number of anomalies in the many studies seeking to account for it. We propose that existing data can no longer be reconciled with the received wisdom about the exceptional role of sex in the African AIDS epidemic…Yaounde (in Cameroon, a nation with low and stable prevalence) had the highest level of risky behavioural markers. Ndola (in Zambia, a nation that has experienced a rapid rise in HIV) had the smallest proportion of both men and women who reported a non-spousal sex partner in the previous 12 months. Ndola’s other markers were similar to those in Dakar, Senegal and Cotonou, Benin, other areas with low, stable prevalence…We are aware of no study from sub-Saharan Africa suggesting cyclic sexual network architecture. Without evidence of appropriate network configurations on a scale considerably larger than that observed in developed countries, rapid propagation of HIV in Africa would be difficult to sustain…Similarly, there are persistent reports of HIV in infants with seronegative mothers.”

  • Brewer DD et al. Mounting anomalies in the epidemiology of HIV in Africa: cry the beloved paradigm. Int J STD AIDS. 2003;14:144-7.

“The conventional wisdom that heterosexual transmission accounts for most adult HIV infections in Africa emerged as a consensus among influential HIV/AIDS experts no later than 1988. In that year, the World Health Organization’s (WHO) Global Program on AIDS circulated estimates that 80% of HIV infections in Africa was due to heterosexual transmission…By mid-1989, an overview of global HIV epidemiology by leading AIDS experts at the Fifth International Conference on AIDS, did not even mention medical injections as a risk for HIV…[based on 13 studies up to 1988] 7 PAFs [Population Attributable Fraction, the portion of HIV infection estimated due to a single cause] for HIV associated with injections average 48%…The 14 available PAFs for risk by blood transfusion average 5%. 4 PAFs for scarification range from <0% to 23% and average 6%. The 9 reflecting risk for reporting more than one sexual partner average 16%. The 3 for contact with prostitute women average 36%. Lastly, the 12 for reported or current STD average 27%…[Reasons why the association of medical injections with HIV might have been ignored include] First, it was in the interests of AIDS researchers in developed countries—where HIV seemed stubbornly confined to MSMs, IDUs, and their partners—to present AIDS in Africa as a heterosexual epidemic…Second, there may have been an inclination to emphasize sexual transmission as an argument for condom promotion, coinciding with pre-existing programmes and efforts to curb Africa’s rapid population growth. Third, ‘the role of sexual promiscuity in the spread of AIDs in Africa appears to have evolved in part out of prior assumptions about the sexuality of Africans’…Fourth, health professionals in WHO and elsewhere worried that public discussion of HIV risks during health care might lead people to avoid immunizations.”

  • Gisselquist D et al. Let it be sexual: how health care transmission of AIDS in Africa was ignored. Int J STD AIDS. 2003;14:148-161.

“Compared with group C [routine health services], the incidence rate ratio of HIV-1 was 0·94 in group A [behavioural interventions against STDs] and 1·00 in group B [behavioural interventions and STI treatment], and the prevalence ratio of use of condoms with last casual partner was 1·12 in group A and 1·27 in group B. Incidence of…active syphilis…and prevalence of gonorrhoea were both lower in group B than in group C [i.e. the interventions had no significant effect on rates of HIV positivity, even though they did reduce rates of sexually transmitted diseases, and did encourage use of condoms]”

  • Kamali A et al. Syndromic management of sexually-transmitted infections and behaviour change interventions on transmission of HIV-1 in rural Uganda: a community randomised trial. Lancet. 2003 Feb 22;361(9358).

“Of the 97 women who volunteered to disclose their history of risk factors for HIV-1 infection, 5 (5%) used to be commercial sex workers [and others reported risk factors with their husbands]…1 woman had late latent syphilis diagnosed, and 8 women (7.5%) were hepatitis B virus carriers. Of the 62 husbands who were also tested for anti-HIV-1 antibody, 18 (29%) were seronegative.”

  • Chaisilwattana P et al. Short-course therapy with zidovudine plus lamivudine for prevention of mother-to-child transmission of human immunodeficiency virus type 1 in Thailand. Clin Infect Dis. 2002 Dec 1;35(11):1405-13.

“Epidemiologists who design computer models to support heterosexual transmission’s role in fuelling Africa’s HIV epidemic characteristically choose and/or adjust assumptions about sexual behaviour, rates of heterosexual transmission, and/or other parameters to allow the model to reproduce observed prevalence. These assumptions are often distant from empiric observations from African studies. While such models show that it is possible to imagine patterns of heterosexual transmission that can `explain’ the epidemic, they do not show that imagined patterns are realistic.

In one model, for example, Anderson and colleagues assumed a mean rate of annual partner change of 3.4. In contrast, surveys in 12 African countries show unweighted averages of 74% of men and 91% of women aged 15– 49 years with no non-regular sex partners in the past year, and only 3.7% of men and 0.7% of women with more than four non-regular partners. At about the same time, a survey in Denmark found that 19% of adults aged 18–59 years reported more than one sex partner in the past year; a survey in France found that 17% of men and 7.9% of women aged 18–44 years reported more than one sex partner in the past year; and a survey in the UK found that 17% of men and 8.4% of women aged 16–44 years reported more than one sex partner in the past year.

Studies of sexual behaviour do not show as much partner change in Africa as modellers have assumed, nor do they show differences in heterosexual behaviour between Africa and Europe that could explain major differences in epidemic growth. During the last 14 years, a number of studies have reported adults contracting HIV without sexual exposures to HIV. A study in Zimbabwe in the 1990s found 2.1% HIV prevalence among 933 women with no sexual experience. In a 1988 study of discordant couples in Rwanda, 15 of 25 HIV-positive women with HIV-negative partners reported only one lifetime sex partner. In a 1990 study of teenagers in Uganda, 6.9% of women with no sex partners in the last five years were HIV-positive vs 23% for those with one or more partners; for men, 1% with no partners in the last five years were HIV-positive vs 2.5% of those reporting partners.

Among young adults 15–24 years old in Tanzania, a 1995 study found HIV prevalence of 5.6% among men and 3.6% among women who did not report any lifetime sexual activity vs 4.8% and 12% for men and women reporting one or more sexual partners. In a 1999 study in South Africa, 6.8% of women and 1.2% of men 14–24 years old who reported never having sex were HIV-positive; however, a validation study found some under-reporting of sexual activity. In a case–control study in Uganda, in two of seven cases with only one lifetime sexual partner, the partner was HIV-negative, three were HIV-positive, and two others not tested.”

  • Gisselquist D et al. HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission. Int J STD AIDS. 2002 Oct;13(10):657-66.

“The maintenance of seronegativity despite exposure to HIV has been observed in sexual partners of HIV infected persons [7 references given], infants born to HIV-infected mothers [3 references], commercial sex workers [4 references] and health care workers occupationally exposed to HIV-contaminated body fluids [2 references]”

  • Makedonas G et al. HIV-specific CD8 T-cell activity in uninfected injection drug users is associated with maintenance of seronegativity. AIDS. 2002 Aug 16;16(12):1595-602.

“The prevalence of HIV infection in Africa is substantially higher among young women than it is among young men. Biological explanations of this difference have been presented but there has been little exploration of social factors. In this paper we use data from Carletonville, South Africa to explore various social explanations for greater female infection rates…[in Carletonville] at 15 years-of-age…an estimated 0.2% of men and 8% of women are HIV-positive; at 20 years-of-age 11% of men and 47% of women are positive…The age at sexual debut cannot explain the dramatic differences in the age-prevalence of HIV infection…

For the younger age-group there is a small, and [statistically] significant, difference between the proportions of men and women who have different numbers of sexual partners. Girls are less likely to have had no partners and more likely to have had one or two…but none of the individual comparisons is significant and the overall distributions are similar…[the only positive association is found when the researchers] plotted the prevalence of infection in women against their age and the prevalence in men against the age of their sexual partners and scaled the prevalence in men up by a factor of 1.3 [but this is still no explanation for the lower HIV seroprevalence rate in men]”

  • MacPhail C et al. Relative risk of HIV infection among young men and women in a South African township.. Int J STD AIDS . 2002 May ;13 (5 ):331-42 .

“The study cohort consisted of 17 women who remained uninfected, despite a history of heavy exposure to HIV through repeated, unprotected sexual contact with an infected partner, and 12 of their regular, male HIV-positive partners. Criteria for inclusion were longstanding sexual partnership up to the time of the male partner’s first positive HIV test and/or continued unprotected intercourse after the male partner was infected and no other identified risk for HIV infection for the women.

The HIV-negative status of the women was determined by HIV-1 antibody status, qualitative plasma DNA polymerase chain reaction, and cocultivation. HIV antibody–positive status was confirmed by repeat ELISA and Western blot tests…At enrollment, CD4 cell counts for the 12 HIV-positive male partners were 9–1903 cells/mm-cubed. In men, these high values were relatively stable during the observation period, as illustrated by the medians over time…In all, 13 women exhibited an immune response that could at least partly explain their persistent seronegativity…The lack of transmission cannot be ascribed to reduction in CD4 cell infectivity. The CD4 cells of 9 women all were readily infected, 5 by their partner’s virus. None of the women was homozygous for CCR5D32 or CCR2 promoter region mutations that disable receptors for HIV.”

  • Skurnick JH et al. Correlates of Nontransmission in US Women at High Risk of Human Immunodeficiency Virus Type 1 Infection through Sexual Exposure. J Infect Dis. 2002 Jan 17;185.

“Overall, 26% of individuals in Kisumu and 28% in Ndola were HIV-positive. In both sites, HIV prevalence in women was six times that in men among sexually active 1 5-19 year olds, three times that in men among 20-24 year olds, and equal to that in men among 25-49 year olds. Age at sexual debut was similar in men and women, and men had more partners than women. Women married younger than men and marriage was a risk factor for HIV, but the disparity in HIV prevalence was present in both married and unmarried individuals. Women often had older partners, and men rarely had partners much older than themselves. Nevertheless, the estimated prevalence of HIV in the partners of unmarried men aged under 20 was as high as that for unmarried women. HIV prevalence was very high even among women reporting one lifetime partner and few episodes of sexual intercourse.”

  • Glynn JR et al. Why do young women have a much higher prevalence of HIV than young men? A study in Kisumu, Kenya and Ndola, Zambia. AIDS. 2001 Aug;15 Suppl 4:S51-60.

“A total of 1022 heterosexual couples with discordant HIV-1 serology results (one partner HIV infected, the other HIV uninfected) were enrolled in a prospective study in Lusaka, Zambia and monitored at 3-month intervals…Median plasma VL [viral load] was significantly higher in transmitters than nontransmitters…the risk ratio (RR) for FTM [female-to-male] transmission was 7.6 for VL > 100,000 copies/ ml and 4.1 for VL between 10,000 and 100,000 copies/ml compared with the reference group of 1 year) with an infected man had 70% less risk of seroconversion…Small and nonsignificant risks were observed among women reporting a higher frequency of sexual intercourse. This result does not agree with what we observed in the cross-sectional part of the study, where women reporting sexual intercourse more than two times weekly had a twofold risk increase. A lack of consistency of the risk of transmission per each single sexual act with an infected person has been noted in other studies…No seroconversion was observed among the 22 women using oral contraceptives [although no reason is given]…[Note that this study did not consider other factors, such as drug use, that may be correlated with frequency of sexual intercourse, immune system health, anal intercourse and type of birth control used]”

  • Saracco A et al. Man-to-woman sexual transmission of HIV: longitudinal study of 343 steady partners of infected men. J Acquir Immune Defic Syndr. 1993 May;6(5):497-502.

“a history of multiple sexual partners was an independent predictor of HIV infection in women. However, about one fifth (21%) of the HIV-infected women in this study had sexual histories that were unremarkable as compared with those of other groups of women in the United States. In 1988 and 1989, surveys of national samples of adults found that the mean number of sexual partners for women was 3.3. In a study of the sexual behavior of college women in 1989, 52% reported having had two to five sexual partners, and 21 percent reported six or more partners. In a study of women attending family-planning clinics in 1987, 13% reported 3 or more sexual partners in the preceding year [and higher levels of sexual partners is sometimes associated with drug use and prostitution, which is associated with race, socio-economic status and so on]”

  • Ellerbrock TV et al. Heterosexually transmitted human immunodeficiency virus infection among pregnant women in a rural Florida community. N Engl J Med. 1992 Dec 10;327(24):1704-9.

“41 antibody-negative heterosexual partners of HIV-infected persons were also PCR-negative [i.e. after repeated exposure to HIV, these 41 people persistently remained negative by both antibody and PCR tests]”

  • Horsburgh CR et al. Concordance of polymerase chain reaction with HIV antibody detection. J Infect Dis. 1990 Aug;162:542-5.

“In 85% of these infected couples, only one member was HIV-1 seropositive despite repeated unprotected sex…A correlation between a recent history of having had sex with a prostitute and HIV-1 seropositivity could not be demonstrated in men who did not have a past history of GUD [genito-urinary disease]”

  • Ryder RW et al. Heterosexual transmission of HIV-1 among employees and their spouses at two large businesses in Zaire.. AIDS. 1990 Aug 4;4(8):725-32.

“of >1,600 investigated monogamous sex partners of [HIV]-infected persons in North America and Europe, only about 15% are infected with HIV…this may be an overestimate…since some partners of intravenous drug abusers may share needles with infected mates…90% of 777 infected hemophilic men have not transmitted HIV-1 to their monogamous sexual partners…24 women who had >100 unprotected genital episodes with their transfusion-infected husbands…remained uninfected”

  • Holmberg SD et al. Biologic factors in the sexual transmission of human immunodeficiency virus. J Infect Dis. 1989 Jul;160(1):116-25.

“Between 1984 and 1987, 56 reportedly asymptomatic female sex partners of HIV-infected hemophilic men were enrolled…Category A comprised the 35 women whose male partner had developed AIDS [30/35], AIDS-related complex (ARC), or peripheral generalized lymphadenopathy…At the time of enrollment of the most recent of these women in April 1987, they represented the spouses/steady sex partners of approximately 10% of the hemophilic men with AIDS in the United States. Category B comprised 21 women identified as sex partners of asymptomatic HIV-infected hemophilic men…Of the 35 women in category A…four (11%) were seropositive at initial evaluation…Of the 7 seronegative women retested approximately 1 year later, none had seroconverted. Of the 21 women in category B, one (5%) was seropositive at enrollment. Of the 12…who were re-evaluated, one was reported in 1986 to have seroconverted [10%]…Category A women were similar in age and in several aspects of general sex practices to category B women…28% had partners who used condoms at least ‘sometimes’, only 12% used them ‘nearly always’…[in conclusion] the two groups did not differ significantly with respect to the [sexual] activities”

  • Lawrence DN et al. Sex practice correlates of human immunodeficiency virus transmission and acquired immunodeficiency syndrome incidence in heterosexual partners and offspring of U.S. hemophilic men. Am J Hematol. 1989 Feb;30(2):68-76.

“In one study, none of the husbands of four seropositive women were infected despite regular sexual contact for as long as three years. In another study involving 12 couples, no transmission from the infected woman to the male partner occurred after more than 100 sexual contacts. Thus, vaginal intercourse may carry a low risk to the insertive partner, as does anal intercourse.”

  • Levy JA. The transmission of AIDS: the case of the infected cell. JAMA. 1988 May 20;259(20):3037-8.

“Of the 4911 consecutive patients [attending a Baltimore city clinic for sexually transmitted diseases] from whom serum was obtained, 256 (5.2%) were seropositive for HIV…No significant association was found between HIV-antibody status and a history of blood transfusions since 1978, sex with a prostitute, or the number of sexual partners in the previous month.”

  • Quinn TC et al. Human immunodeficiency virus infection among patients attending clinics for sexually transmitted diseases. N Engl J Med. 1988 Jan 28;318(4):197-203.

“Antibody [to HIV] was found in 2 of 25 husbands [of HIV-positive women] and 10 of 55 wives [of HIV-positive men]. One infected woman had had only a single sexual contact, and another had only eight. Eleven wives [of HIV-positive men] remained uninfected after more than 200 sexual contacts with their infected spouse. Compared with the seronegative wives, the seropositive wives tended to have fewer sexual contacts [!], although the difference was not statistically significant…Condoms were rarely used”

  • Peterman TA et al. Risk of Human Immunodeficiency Virus transmission from heterosexual adults with transfusion-associated infections. JAMA. 1988 Jan 1;259(1):55-8.

“The total number of exposures to the index case (sexual contacts with ejaculation [with the HIV+ partner]) and the specific practice of anal intercourse, also with the infected partner, were associated with transmission. Neither condom use, total number of sexual partners since 1978, nor lifetime number of sexually transmitted diseases was associated with infection.”

  • Padian N et al. Male-to-female transmission of human immunodeficiency virus. JAMA. 1987 Aug 14;258(6):788-90.

“All 4 HIV seropositive women [wives of hemophliacs] with available data had vaginal intercourse without a condom, but risk of seropositivity did not appear to be affected by the frequency of vaginal intercourse or by hysterectomy.”

Goedert JJ et al. Heterosexual transmission of human immunodeficiency virus: association with severe depletion of T-helper lymphocytes in men with hemophilia. AIDS Res Hum Retro. 1987;3(4):355-61.

“From Oct 15 through 25, 1984, 2400 Mama Yemo Hospital employees were enrolled in [this] study…Seroprevalence was significantly higher among women than among men…[and] was higher among unmmarried persons than among married persons.”

  • Mann JM et al. HIV seroprevalence among hospital workers in Kinshasa, Zaire. Lack of association with occupational exposure. JAMA. 1986 Dec 12;256(22):3099-102.

“41 sequential cases of HTLV-III disease (ARC/AIDS) were evaluated…In 15 (37%) of 41 patients…HTLV-II infection appeared to have been heterosexually acquired. This included 10 males and 5 females. Exposure to HTLV-III was confirmed by virus isolation in 11 of these 15 patients, and all 15 patients demonstrated serum antibody to HTLV-III structural proteins by Western blot techniques [omitting the 2 or 3 ELISA tests that are now standard practice to reduce false positives on Western Blots]…HTLV-III was most likely to have been acquired by recurrent heterosexual contact with a sexual partner who was a member of a high-risk group for AIDS in three patients [but the other 12 had no documented contact with an HIV positive person and only 7 of the 15 had AIDS rather than ARC]”

  • Redfield RR et al. Heterosexually acquired HTLV-III/LAV disease (AIDS-related complex and AIDS). Epidemiologic evidence for female-to-male transmission. JAMA. 1985 Oct 18;254(15):2094-6.

“…despite a high prevalence of asymptomatic clinical and immunologic abnormalities in the hemophiliacs, we found their wives, on average, to be normal with respect to T-cell subsets and other surrogate laboratory markers”

  • Kreiss JK et al. Antibody to human T-lymphotropic virus type III in wives of hemophiliacs. Ann Intern Med. 1985 May;102(5):623-6.

“7 cases of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) associated with human T-cell leukemia (lymphotropic) virus (HTLV)-III [HIV] infection were documented in married males whose family members consented to medical evaluation. Five spouses also had evidence of HTLV-III infection documented by isolation of virus and [incorrect, should be ‘or’] by detection of serum antibody directed against viral structural proteins [2 of 6 tested had virus ‘isolated’ and 4 of 7 tested had antibody. 2 were negative by both isolation and antibody testing]. Three of the five HTLV-positive spouses also had clinical evidence of ARC. The remaining four spouses were clinically healthy…[notwithstanding these limitations, the authors claim] These data support the opinion that close household contact to patients with ARC or AIDS is not an efficient mechanism for virus transmission, while demonstrating that HTLV-III can be transmitted by repeated heterosexual contact.”

  • Redfield RR et al. Frequent transmission of HTLV-III among spouses of patients with AIDS-related complex and AIDS. JAMA. 1985 Mar 15;253(11):1571-3.

“65% of [hemophiliac, clotting factor] concentrate recipients had an abnormal T-helper to T-suppressor cell ratio, 40% had a depressed absolute T-helper cell level, and 29% had an elevated absolute T-suppressor cell count. To determine whether horizontal transmission of T-cell subset abnormalities from hemophiliacs to their female sexual partners occurred, we studied 41 spouses. We found no correlation between paired husband and wife values for T-cell ratio or any other immune parameter studied…We conclude that there is no evidence to date for heterosexual or household-contact transmission of T-cell subset abnormalities from hemophiliacs to their spouses in our study population.”

  • Kreiss JK et al. Nontransmission of T-cell subset abnormalities from hemophiliacs to their spouses. JAMA. 1984 Mar 16;251(11):1450-4.

“5 apparently healthy wives of asymptomatic factor-VIII-deficient [hemophiliac] patients who had OKT4/T8 [CD4/CD8] ratios of less than 1 were…studied…All of these women had regular sexual relations with their husbands, and often assisted in administration of their factor VIII concentrate therapy…The lymphocyte proliferative responses of the wives were normal, and their lymphocyte subpopulation ratios, although lower, were not significantly different from control values…[because there was no control group] the abnormalities…could be related to factors other than sexual contact with their hemophiliac husbands”

  • deShazo RD et al. An immunologic evaluation of hemophiliac patients and their wives. Relationships to the acquired immunodeficiency syndrome. Ann Intern Med. 1983 Aug;99(2):159-64.

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