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Current HIV Research
ISSN (Print): 1570-162X
ISSN (Online): 1873-4251
VOLUME: 1
ISSUE: 1
DOI: 10.2174/1570162033352110









Measuring the Infectiousness of Persons with HIV-1: Opportunities for Preventing Sexual HIV-1 Transmission

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Author(s): Jared M. Baeten and Julie Overbaugh
Pages 69-89 (21)
Abstract:
Methods to reduce sexual transmission of HIV-1 are urgently needed to slow the global HIV-1 epidemic. These methods should include interventions that minimize susceptibility in uninfected populations at risk, as well as interventions that decrease the infectiousness of HIV-1 infected individuals. Surprisingly few interventions to prevent HIV-1 transmission have been targeted at persons who are already infected, although such interventions could have a significant impact on population-wide HIV-1 spread. This review summarizes current knowledge of factors that influence HIV-1 infectiousness, with special attention on the role of genital tract HIV-1 as a surrogate marker of infectiousness. Epidemiologic studies have demonstrated good agreement between factors associated with increased HIV-1 transmission and increased HIV-1 genital tract shedding. Treatment of sexually transmitted diseases and initiation of antiretroviral therapy have been shown to reduce HIV-1 shedding and thus are promising interventions that may reduce HIV-1 transmission. Unresolved issues related to optimal measurement techniques for genital HIV-1, promises and limitations of antiretroviral therapy and vaccines to reduce infectiousness, and other intervention strategies still in development are reviewed.
Keywords:
hiv-1, transmission, shedding, infectivity, sexual transmission
Affiliation:
University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA 98104-2499, USA