Neither Padian, Gisselquist or Brody provide any reason to believe HIV isn't sexually transmitted... 26 March 2003
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Tony Floyd,
Medical Student
Newcastle University, Newcastle Australia

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Re: Neither Padian, Gisselquist or Brody provide any reason to believe HIV isn't sexually transmitted...

It has been stated above that the Padian paper(1) does not PROVE that heterosexual transmission occurs.

No argument there.

My point is that it doesn't PROVE that heterosexual transmission of HIV DOESN'T occur. As has been acknowledged, condom use did decline during the study period (although as many as 25% of the participants still admitted to inconsistent use by the end of the study period.)

I'll stand by my reasons as to why Padian's paper does not prove that HIV can't be transmitted sexually:

Although there were no NEW transmissions during the study period:

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1. All participants were aware that they were with a HIV-positive partner.

2. They all new that they were part of a study examining transmission.

3. It (might be) safe to assume that none of the participants wanted to be infected.

4. The group studied are all from a wealthy country which was saturated with AIDS education.

5. Condom use increased substantially during the study period.

6. Anal sex decreased substantially during the study period.

7. The whole world does not live in North Carolina.
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It is also claimed above that:

According to Gisselquist and his colleagues "HIV is not transmitted by ‘sex’...

REALLY??? Where is that written?

Unless you can get Gisselquist or one of the other researchers to confirm such a comment, one can only go by what they have put into print.

For example in a letter right here in the BMJ(2) (in the final paragraph):

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"Although cofactors such as sexually transmitted diseases and lack of circumcision may boost heterosexual transmission..."
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Sure, he is questioning if non-sexual transmission has been overlooked, but he does comment on factors BOOSTING heterosexual transmission!.

Stuart Brody is also cited, and his 1995 paper does state that intravenous and anal activities remain the only clear vectors for HIV transmission.

Does Brody still hold this view now?

His 1997 book(3) refers to the Low AIDS Risk of Vaginal Intercourse.

Not no risk, low risk. AND he is referring to a low risk in modern countries, where the presence of cofactors such as other sexually transmitted diseases(2) is much lower.

References:

(1) Padian NS. Shiboski SC. Glass SO. Vittinghoff E. Heterosexual transmission of human immunodeficiency virus (HIV) in northern California: results from a ten-year study. American Journal of Epidemiology. 146(4):350-7, 1997 Aug 15. [Abstract]

(2) Gisselquist D, Rothenberg R, Potterat J, Drucker E. Non-sexual transmission of HIV has been overlooked in developing countries. BMJ. 2002 Jan 26;324(7331):235.

(3) Brody S. Sex at Risk: Lifetime Number of Partners, Frequency of Intercourse, and the Low AIDS Risk of Vaginal Intercourse. New Brunswick, NJ: Transaction Publishers, 1997: 109–168 [amazon.com Link]

Competing interests:   None declared