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Sexually Transmitted Diseases:
Article

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, BEENA PhD; MAHER, JULIE E. PhD; PETERMAN, THOMAS A. MD; BRANSON, BERNARD M. MD, AND; STEKETEE, RICHARD W. MD

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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.

© Copyright 2002 American Sexually Transmitted Diseases Association

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