Human immunodeficiency virus infection, hepatitis B virus infection, and sexual behaviour of women attending a genitourinary medicine clinice
Authors: B. A Evans, S. M McCormack, R. A Bond, K. D MacRae, R. W Thorp
Journal: BMJ (1988)

During the six months immediately after a public information campaign about the acquired immune deficiency syndrome 1115 women who attended a genitourinary medicine clinic in west London were tested for antibodies to the human immunodeficiency virus (HIV). Three women (0.27%) were positive, and all three were regular sexual partners of men with high risk lifestyles--two intravenous drug users and one bisexual. A consecutive series of 647 women from the cohort was tested for antibodies for hepatitis B core antigen: 27 were positive, of whom six had been born in the United Kingdom and were not known to have been at risk. The two women who were seropositive for HIV who completed a questionnaire on their sexual behaviour before they were tested reported both anal and oral receipt of semen and were in the upper fifth percentile for lifetime sexual partners. More than half (53%) of 424 women who reported that they had non-regular sexual partners never used a condom. It is concluded that heterosexual women in London are at a low risk of becoming infected with HIV.A cohort of women were screened for sexual behavior and for antibodies to HIV and hepatitis B. These women attended a clinic for sexually transmitted diseases in an area of London where homosexual men have a high prevalence of both infections. The spread of AIDS among heterosexuals is likely to appear 1st in women who are partners of bisexual men and in localities where the prevalence of HIV infection in homosexual men is the highest. Of 115 women who were tested, 3 women (0.27%) were positive, and all 3 were regular sexual partners of men with high risk lifestyles--2 intravenous drug users and 1 bisexual. A consecutive series of 647 women from the cohort was tested for antibodies for hepatitis B core antigen: 27 were positive, of whom 6 had been born in the U.K. and were not known to have been at risk. The 2 who were seropositive for HIV and who had completed a questionaire on their sexual behavior before testing reported both anal and oral receipt of semen and were in the upper 5th percentile for lifetime sexual partners. More than 1/2 (53%) of 424 women who reported that they had nonregular sexual partners never used a condom. Patients at risk for HIV infection are also at greater risk of hepatitis B infection. Prevalence of hepatitis B infection among patients in genito-urinary medicine clinics has been reported at 4% to 8% for women compared with 4% to 18% for heterosexual men and 19% to 76% for homosexual men. Women in west London showed a low prevalence of hepatitis B, and most of those women were born outside the U.K. and may have been infected since childhood. The advice of a recent national campaign to use condoms seems to have had little effect. However, it appears from this group of women that there is no evidence of HIV infection being spread from casual vaginal intercourse. The risk of becoming infected with HIV for heterosexual women in London is very low and is likely to remain so if the epidemiological parallel with hepatitis B is valid.