BMJ. 1989 Feb 18;298(6671):411-5. doi: 10.1136/bmj.298.6671.411.
To identify risk factors for sexual transmission of HIV from infected men to their female sexual partners.
Cross sectional analysis as part of a continuing study. Data were obtained by interviewing heterosexual couples in which the man was infected with HIV. Risks were assessed by comparing couples in which transmission had occurred (woman infected with HIV) with those in which it had not (woman not infected) and estimated by independent odds ratios and their 95% confidence intervals.
Infectious disease and public health departments from nine centres in six European countries.
153 Male index patients (mean age 30.4 years) and their 155 female partners (mean age 27.8 years).
Women were tested to determine their HIV antibody state. Women with a risk of infection with HIV other than sexual contact with their infected partner were excluded.
Three risk factors for male to female transmission of HIV.
Three risk factors were identified: a history of sexually transmitted disease in the previous five years for the female partner (odds ratio 3.1, 95% confidence interval 1.1 to 8.6); index patient with full blown AIDS (5.4, 1.2 to 25.2); and practice of anal intercourse (5.8, 2.3 to 14.8). The proportion of women positive for HIV antibody was 27% (42/155), ranging from 7% (1 to 13%) (4/60) for couples with none of the three risk factors to 67% (45 to 89%) (12/18) for those with two or three of the risk factors. Duration of the relationship (median three years), frequency of sexual contacts, sexual practices other than anal intercourse, and contraceptive behaviour were not associated with infection of the partner.
The risk of sexual transmission of HIV from an infected man to his female partner varies considerably according to the characteristics of the couple. The differences in rates of transmission in high risk groups may be considerably reduced if the risk factors are taken into account during individual and public health counselling.
确定人类免疫缺陷病毒（HIV）从感染男性传播至其女性性伴侣的危险因素。
作为一项持续性研究的一部分进行横断面分析。通过对男性感染HIV的异性恋伴侣进行访谈获取数据。通过比较已发生传播的伴侣（女性感染HIV）和未发生传播的伴侣（女性未感染）评估风险，并通过独立比值比及其95%置信区间进行估计。
六个欧洲国家九个中心的传染病和公共卫生部门。
153名男性索引患者（平均年龄30.4岁）及其155名女性伴侣（平均年龄27.8岁）。
对女性进行检测以确定其HIV抗体状态。排除有除与感染伴侣性接触以外的HIV感染风险的女性。
HIV从男性传播至女性的三个危险因素。
确定了三个危险因素：女性伴侣在过去五年中有性传播疾病史（比值比3.1，95%置信区间1.1至8.6）；索引患者患有全面性艾滋病（5.4，1.2至25.2）；以及肛交行为（5.8，2.3至14.8）。HIV抗体呈阳性的女性比例为27%（42/155），在无这三个危险因素的伴侣中为7%（1至13%）（4/60），在有两个或三个危险因素的伴侣中为67%（45至89%）（12/18）。关系持续时间（中位数三年）、性接触频率、除肛交以外的性行为以及避孕行为与伴侣感染无关。
根据伴侣的特征，HIV从感染男性传播至其女性伴侣的性传播风险差异很大。如果在个体和公共卫生咨询中考虑到危险因素，高风险群体中传播率的差异可能会大幅降低。
