Is Sex between HIV-positives perilo

Dmitry Yuryev yur77 at glas.apc.org
Sat Jan 20 07:16:07 EST 1996


   I would like to attract attention to a rather important
practically problem which seems to be completely overlooked 
both by science and by AIDS activists.
   There is an absolutely obvious reason to think that sex 
between HIV-positive partners may trigger the onset  of AIDS in 
both of them.
   Indeed, there are too many different antigenic forms of 
HIV and every its carrier has several of them. Therefore if  
partners have "different AIDSes" both are at risk to catch 
additional antigenic forms (it is called superinfection).
   The question whether "more AIDSes" means progress to 
development of disease is not trivial. The common sense says, of 
course, that it does. And there was a nice mathematical model by 
M.Nowak & R.May (e.g.: Science (1991), 254:963) based on this 
assumption. They recently published a protracted article in 
Sci.American (Aug.1995, page58), so this point of view seems to be
a mainstream one.
   Then, there is a "heretic" phenomenon (used mostly by 
P.H.Duesberg) correlating with this view that HIV-positives 
continuing promiscuous lifestyle are at higher risk of developing 
AIDS.
   Yet, objections also exist. 
   First, model by Nowak was developed neglecting (rather 
absurdly, I think) the possibility of superinfections and even 
opportunity to catch several antigenic forms at the moment of 
primary infection. So, in the present context this work should be 
considered merely as an avowing of "common sense" idea 
proving, actually, nothing.
   Second, most serious, there are data about patients with 
well over a thousand partners who, obviously, had to get virus at 
least from dozens of sources. Yet the did not develop any 
unusual (accelerated) forms of AIDS. Some researchers at early 
days (Hahn B.H. et.al., Science(1986), 232:1548) even 
suggested on this bases that superinfections are somehow 
hindered by unknown mechanisms. Yet, today that is clearly not 
true.
   Thus, the conclusion should be drawn that it is not known 
whether "sharing" of HIV's antigenic forms is perilous. 
Apparently, the more probable and more mainstream answer is 
"Yes". If so, the propaganda of "safe sex" among HIV-positives
should be conducted with no less persistense as among the rest
of population.
   Yet, of course, this problem deserve more definite 
investigation which seems to be not difficult to perform having
access to appropriate statistics



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