HIV infectivity: information from epidemiological studies of heterosexual transmission.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

HIV infectivity: information from epidemiological studies of heterosexual transmission.

Int Conf AIDS. 1996 Jul 7-12;11(1):42 (abstract no. Mo.C.573). Unique Identifier : AIDSLINE MED/96921015
Shiboski S; Padian N; Department of Epidemiology & Biostatistics, University of California; San Francisco (UCSF), San Francisco, CA. Fax: (415) 476-6014. E-mail:; steve@biostat.ucsf.edu.

Abstract: Objective: To investigate the utility of epidemiological studies of heterosexual HIV transmission in providing quantitative information about properties of the infectivity, or per contact infection risk. Also, to present methods for analysis of data from studies of HIV transmission which make appropriate use of exposure information. Methods: Data from three CDC-sponsored studies of transmission in partners of previously infected individuals are used to estimate infectivity: two based on partners of individuals infected via transfusion, and one consisting of partners of individuals infected from a variety of sources. Newly developed statistical methods which account for the incomplete nature of the exposure data from these studies are used to estimate the infectivity and associated estimation error, to investigate effects of behavioral risk factors and to assess evidence for heterogeneity of infectivity across partnerships. Infectivity estimates from other studies and biological data on HIV infectivity are also reviewed. Results: Estimates of the constant per-contact infectivity from the three studies are similar, ranging from 0.0009 to 0.002 with overlapping 95% confidence intervals. Additional non-parametric estimates show some evidence for variation with time following infection of the primary infected partner, and for heterogeneity across partnerships. Due to the incompleteness of the exposure data and to large uncertainty in the estimates, little can be concluded about how the infectivity changes with time. In particular, no information is provided about change in the period immediately following infection of the primary infected partner. Conclusions: Although epidemiological studies provide useful information on risk factors for transmission, they do not yield reliable estimates of HIV infectivity unless it is assumed to be constant over time and across partnerships. These limitations are largely due to the inadequacy of available exposure data. More complete exposure information and additional data on biological properties of infectiousness and susceptibility are needed for better estimates.

Keywords: *HIV Infections/TRANSMISSION *Sex Behavior
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