INCREASING INCIDENCE OF HETEROSEXUAL TRANSMISSION OF THE HUMAN IMMUNODEFICIENCY VIRUS (HIV) IN MOTHERS OF INFANTS WITH AIDS OR ARC

Abstract

Most children with HIV infection in the U.S.A. acquire their disease in utero. We have retrospectively evaluated the route of HIV infection in mothers of children with proven HIV infection. A detailed history of paternal and maternal intravenous drug abuse (IVDA), blood transfusion, and sexual contacts with people at risk for HIV infection was obtained independently by a physician, nurse, and social worker. Sixty-six cases in which history was questionable were excluded. Eighty-eight infants seropositive for HIV (by ELISA and Western Blot) with symptoms and signs consistant with AIDS or ARC born between 1978 and 1986 were used as index cases. Over the past 2 years we have noticed an increase in women whose only known risk factor was heterosexual contact with HIV positive men. All 14 infants born between 1978-1980 were born to IV drug abusing mothers. Two of 35 (6%) infants born in 1981 and 1982 were infants of mothers in whom the only identifiable risk factor was heterosexual contact with an HIV seropositive male. In the years 1983 and 1984, 2 of 24 (8%) infants were born to women with similar risks. However, 7 of 16 (44%) of HIV infected infants born in 1985 and 1986 were born to mothers with only heterosexual contact as their risk factor (P 0.005). This study clearly demonstrates an epidemiclogical change in regard to maternal acquisition of HIV infection.