Bidirectional heterosexual transmission of human immunodeficiency virus (HIV)

Abstract

Whereas, in Africa, heterosexual transmission appears to be the predominant mode of transmission of human immunodeficiency virus (HIV), this still seems to be an unusual event in Europe and North America. Bidirectional heterosexual transmission of HIV is now supported by a plethora of biological and epidemiological data, including presence of the virus in semen and cervico-vaginal secretions ; high infection rates in heterosexual partners of male and female patients with AIDS and ARC ; a promiscuous heterosexual life style in African patients and in some European and American cases ; a high frequency of sex contact with female prostitutes in heterosexual men with AIDS ; a high proportion of prostitutes and «free women» among African patients ; high seropositivity rates in prostitutes in some geographic areas ; clusters of cases linked by heterosexual contact. Risk factors associated with heterosexual transmission of HIV remain to be defined. Disruption of genital epithelial integrity or inflammation of the genital tract may favour heterosexual transmission of HIV. In the future, heterosexuals may account for an increasingly larger proportion of the number of patients with AIDS.