Reducing the risk of sexual HIV transmission: Quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use

  • Varghese B
  • Maher J
  • Peterman T
 et al. 
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Abstract

BACKGROUND: Sexual acquisition of HIV is influenced by choice of partner, sex act, and condom use. However, current risk-reduction strategies focus mainly on condom use. GOAL: To estimate the contribution of choice of partner, sex act, and condom use on the per-act relative and absolute risks for HIV infection. STUDY DESIGN: Per-act relative risk for HIV infection was calculated with use of estimates of HIV prevalence, risk of condom failure, HIV test accuracy, and per-act risk of HIV transmission for different sex acts. Absolute risks were calculated on the basis of these relative risk estimates. RESULTS: Choosing a partner who tested negative instead of an untested partner reduced the relative risk of HIV infection 47-fold; using condoms, 20-fold; and choosing insertive fellatio rather than insertive anal sex, 13-fold. Choosing one risk-reduction behavior substantially reduces absolute risk of HIV infection for heterosexuals but not for men who have sex with men. CONCLUSION: Clarifying the magnitude of risk associated with different choices may help people make effective and sustainable changes in behavior.

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Authors

  • Beena Varghese

  • Julie E. Maher

  • Thomas A. Peterman

  • Bernard M. Branson

  • Richard W. Steketee

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