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Canadian Journal of Infectious Diseases
Volume 2, Issue 1, Pages 30-36
Infection and Immunity Symposium

Heterosexual Transmission of Human Immunodeficiency Virus Infection – Strategies for Prevention

Brian Conway,2 D William Cameron,1 Francis A Plummer,1 and Allan R Ronald1

1Departments of Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
2Division of Infections Diseases, Ottawa General Hospital, Ottawa, Ontario, Canada

Copyright © 1991 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In Canada, over 90% of the acquired immune deficiency syndrome cases diagnosed so far have been acquired sexually, with an increasing proportion made up of heterosexual contacts of high risk individuals. In multiple studies, the transmission rate among steady heterosexual partners of infected individuals has been variable. It is likely that complex biological and epidemiological interactions exist between human immunodeficiency virus (HIV) and sexually transmitted diseases with respect to transmission and disease. Other important determinants in transmission of infection may relate to the virus itself. The importance of sexual practices other than vaginal intercourse (such as anal intercourse) in the heterosexual transmission of HIV has not been well studied. The major approach to the control of HIV-associated disease remains the control of primary infection. Sexual practices which are the major epidemiological determinants of HIV transmission can be successfully modified by appropriate educational interventions. The promotion of condom use must form a special part of these interventions. Results of ongoing trials should be available prior to the formulation of recommendations for the use of spermicides. Targeted education programs may allow us to make better use of our resources in a more efficient way. In Canada, groups that could be reached by such programs include: prostitutes and their clients; men and women attending sexually transmitted disease clinics; sexually active women attending family planning clinics; and children and adolescents who are becoming sexually active.