Exposure of Heterosexuals to Human Immunodeficiency Virus and Viremia

There is risk of transmission of human immunodeficiency virus (HIV) in sexually active couples, one of whom is seropositive. However, the frequency of such HIV transmission is not known. We have surveyed a population of monogamous hemophiliacs treated with potentially-infected coagulation factor concentrates during 1980-1984. We found high titers of antibodies to HIV in 24 of 30 hemophiliacs and in four of 30 spouses. The duration of HIV exposure from unprotected sexual intercourse ranged from greater than 12 to 78 months. The acquired immunodeficiency syndrome (AIDS) developed in six hemophiliac husbands, and one seropositive wife has lymphadenopathy. We were concerned that viremia with HIV might be the primary determinant of transmission to the men's wives. Circulating HIV was found in all of four hemophiliacs with AIDS, both of two with AIDS-related complex (ARC), four of 14 asymptomatic hemophiliacs, and two of four seropositive spouses. Isolation of HIV was less likely from asymptomatic hemophiliacs (29%) than from asymptomatic seropositive men (71%) in other high-risk groups. Our studies suggest that HIV was transmitted to 17% of the spouses of hemophiliacs. Efforts to educate all such couples about the risk of HIV infection remain imperative.