Heterosexual and mother-to-child transmission of AIDS in the hemophilia community.

Growing awareness of the potential modes of transmission of the human immunodeficiency virus (HIV) has encouraged interest in the epidemiology of infection among sexual partners and children of HIV-infected persons. The authors reviewed data on two groups, the first being those with HIV infection acquired heterosexually from a person whose hemophilia, or other chronic bleeding disorder, was treated with blood products. The second group was children with HIV infection acquired from a mother (vertical transmission) who either had been treated for a chronic bleeding disorder or had been the heterosexual partner of a person being treated. Surveillance data were examined for cases of acquired immunodeficiency syndrome (AIDS) in the United States reported to the Centers for Disease Control and Prevention, diagnosed before January 1, 1992, and for whom the only identified risk factor was being either the heterosexual partner or the child of a parent with a chronic bleeding disorder. Of the cases examined, 107 were in persons who were heterosexual partners of persons with chronic bleeding disorders. Of the 107, 98 (92 percent) were women and 87 (81 percent) were white; all were 17 years of age or older. In addition to the 107, there were 14 children, 10 (71 percent) of whom were diagnosed with AIDS in the first year of life. The rate of increase in such cases has not been as great in recent years as that observed early in the primary epidemic of AIDS among persons with hemophilia and other chronic bleeding disorders. These data underscore the risk of HIV transmission among heterosexually active couples, if one partner is seropositive, and the risk of transmission to offspring. Estimates of the prevalence of HIV infection among heterosexual women partners of HIV-infected men with hemophilia are comparable to estimates for women who had heterosexual contact with spouses infected with HIV from transfusions with cellular products. However, better data for estimates of persons at risk are needed to obtain more accurate comparisons.