Heterosexual risk of HIV-1 infection per sexual act: a systematic review and meta-analysis of observational studies
By M. Boily, R. Baggaley, Lei Wang, B. Mâsse, R. White, R. Hayes, M. Alary. Lancet. Infectious Diseases (Print), 2009
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We conducted a systematic review and meta-analysis of observational studies of the risk of HIV-1 transmission per heterosexual contact. The search to September 2008 identified 43 publications based on 25 different study populations. Pooled female-to-male (0·0004,95%CI=0·0001-0·0014) and male-to-female (0·0008,CI=0·0006-0·0011) transmission estimates in developed countries reflected a low risk of infection in the absence of antiretrovirals. Developing country female-to-male (0·0038,CI=0·0013-0·0110) and male-to-female (0·0030,CI=0·0014-0·0063) estimates in absence of commercial sex(CS) work were higher. In meta-regression analysis, the infectivity across estimates in absence of CS work was significantly associated with gender, setting, the interaction between setting and gender and HIV prevalence. The pooled receptive anal intercourse estimate was much higher (0·017,CI=0·003-0·089). Estimates for the early and late phase of HIV infection were 9·2(CI=4·5-18·8) and 7·3(CI=4·5-11·9)-fold larger than for the asymptomatic phase, respectively. After adjusting for CS exposure, presence or history of genital ulcers in either couple member increased per-act infectivity 5·3(CI=1·4-19·5)-fold compared to no sexually transmitted infection. Study estimates among non-circumcised men were at least twice those among circumcised men. Developing country estimates were more heterogeneous than developed country estimates, which indicates poorer study quality, greater heterogeneity in risk factors or under-reporting of high-risk behaviour. Efforts are needed to better understand these differences and quantify infectivity in developing countries.
Subfields: General Health Professions, Infectious Diseases, Sociology and Political Science
View Paper: https://www.semanticscholar.org/paper/018894a892c56b7bd8f33f99a4d19e5272c26203
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Citations in the corpus
- Sex Differences in Disgust: Why Are Women More Easily Disgusted Than Men? (2018, background): “Indeed, for a given sex act, the average likelihood of contracting a sexually transmitted infection is higher for women than for men (American Sexual Health Association, 2016; Baggaley, White, & Boily, 2010; Boily et al., 2009).”
- Estimating per-act HIV transmission risk: a systematic review (2014, methodology): “for other sexual exposures were 4 (95% CI 1–14) for insertive penile–vaginal intercourse, 8 (95% CI 6–11) for receptive penile–vaginal intercourse, and 11 (95% CI 4–28) for insertive anal intercourse [7,13,14] (Table 1).”