Detection of HIV-1 DNA sequences in pre-ejaculatory fluid

Ilaria, Gerard; Jacobs, JonathanL.; Polsky, Bruce; Koll, Brian; Baron, Penny; Maclow, Clarinda; Armstrong, Donald; Schlegel, PeterN.

doi:10.1016/0140-6736(92)92658-3

Cited by 63 publications

(28 citation statements)

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“…A European study (De Vicenzi, 1994) suggests that withdrawal provides some protection for male-to-female HIV transmission (but see Ilaria et al, 1992;Pudney, Oneta, Mayer, Seage, & Anderson, 1992). However, we found no studies indicating that the practice protects against any other STIs.…”

Section: Introductioncontrasting

confidence: 51%

Withdrawal (Coitus Interruptus) as a Sexual Risk Reduction Strategy: Perspectives from African-American Adolescents

et al. 2008

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This study examined adolescents' beliefs about the benefits and risks of withdrawal (coitus interruptus) with respect to both pregnancy and sexually transmitted infections (STIs). In the course of qualitative interviews with African-American youth aged 14-19 (n = 124) about sexuality and risk, 24 adolescents spontaneously introduced the subject of withdrawal as a sexual risk reduction strategy. Eighteen percent of the sexually experienced adolescents mentioned their own use of withdrawal as a contraceptive method. From adolescents' accounts of their own and

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Section: Introductioncontrasting

confidence: 51%

Withdrawal (Coitus Interruptus) as a Sexual Risk Reduction Strategy: Perspectives from African-American Adolescents

et al. 2008

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“…Indeed, several studies in therapy-naive men support such a role: urethral swabs were found to contain significant amounts of HIV RNA (96), and HIV RNA and DNA were detected in the preejaculatory fluid coming from the urethra (97,98). Phylogenetic analysis would be needed to demonstrate that the urethra is indeed a source of virus in semen during HAART.…”

Section: Discussionmentioning

confidence: 99%

Detection of Simian Immunodeficiency Virus in Semen, Urethra, and Male Reproductive Organs during Efficient Highly Active Antiretroviral Therapy

Matusali

Dereuddre-Bosquet

Tortorec

et al. 2015

J Virol

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A number of men receiving prolonged suppressive highly active antiretroviral therapy (HAART) still shed human immunodeficiency virus (HIV) in semen. To investigate whether this seminal shedding may be due to poor drug penetration and/or viral production by long-lived cells within male genital tissues, we analyzed semen and reproductive tissues from macaques chronically infected with simian immunodeficiency virus mac251 (SIVmac251) who were treated for 4 months with HAART, which was intensified over the last 7 weeks with an integrase inhibitor. We showed that a subset of treated animals continued shedding SIV in semen despite efficient HAART. This shedding was not associated with low antiretroviral drug concentrations in semen or in testis, epididymis, seminal vesicles, and prostate. HAART had no significant impact on SIV RNA in the urethra, whereas it drastically reduced SIV RNA levels in the prostate and vas deferens and to a lesser extent in the epididymis and seminal vesicle. The only detectable SIV RNA-positive cells within the male genital tract after HAART were urethral macrophages. SIV DNA levels in genital tissues were not decreased by HAART, suggesting the presence throughout the male genital tract of nonproductively infected cells. In conclusion, our results demonstrate that 4 months of HAART induced variable and limited control of viral infection in the male reproductive organs, particularly in the urethra, and suggest that infected long-lived cells in the male genital tract may be involved in persistent seminal shedding during HAART. These results pave the way for further investigations of male genital organ infection in long-term-treated infected individuals. IMPORTANCEA substantial subset of men receiving prolonged HAART suppressing viral loads in the blood still harbor HIV in semen, and cases of sexual transmission have been reported. To understand the origin of this persistence, we analyzed the semen and male reproductive tissues from SIV-infected macaques treated with HAART. We demonstrated that persistent seminal shedding was not linked to poor drug penetration in semen or semen-producing prostate, seminal vesicle, epididymis, and testis. We revealed that HAART decreased SIV RNA to various extents in all male genital organs, with the exception of the urethra, in which SIV RNA ؉ macrophages were observed despite HAART. Importantly, HAART did not impact SIV DNA levels in the male genital organs. These results suggest that infection of male genital organs, and particularly the urethra, could be involved in the release of virus in semen during HAART.A pproximately 35.3 million people worldwide are living with human immunodeficiency virus (HIV)/AIDS, and 2.3 million new infections occur annually (1). Over 80% of these new infections are caused by unprotected sexual intercourse. The risk of sexual transmission of HIV is strongly correlated with HIV RNA levels in genital secretions (2). Because semen is the most common vector of HIV dissemination worldwide (3-5), preventing HIV transmission by...

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“…14 Some 1992 laboratory studies, however, support the argument that oral sex may be risky. Ilaria et al, 15 and Pudney et al, 16 reported finding HIV virus in the preejaculatory fluid of HIV-seropositive men. In 1996, Baba et al reported that the simian immunodeficiency virus (SIV), which is related to HIV, was significantly more transmissible to macaque monkeys through the oral route than through the rectal route.…”

Section: Review Of the Literaturementioning

confidence: 99%

Counseling patients about HIV risk from oral sex

1997

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nprotected oral sex is not well recognized as a risk factor for transmitting the human immunodeficiency virus, yet as evidence of its potential risk accrues, physicians must confront the question of how to counsel patients about oral sex risk. How do health care professionals feel about broaching this topic with their patients? Can the psychological literature help physicians understand their patients' risk perceptions and motivate healthful behaviors? In this article, we review the literature on oral sex risk, discuss barriers to communicating caution to patients, and propose recommendations and specific counseling strategies based on risk perception and behavior change theory that we believe will help physicians effectively intervene in the prevention of HIV transmission. REVIEW OF THE LITERATURESince the advent of the AIDS epidemic, researchers have sought to define categories of risk for transmission of HIV in sexual behavior. Although receptive anal and vaginal intercourse have been clearly classified as the highest-risk behaviors, and kissing and masturbation as behaviors with the lowest risk, 1 the level of risk for oral sex remains a matter of debate. A variety of research methods-human and animal, epidemiologic studies and case reports, in vitro and in vivo-have yielded a growing literature addressing the question of oral sex risk. The comparative riskiness of oral sex in epidemiologic studies attempting to relate behavior to HIV seroconversion has been difficult to assess. These studies attempt the nearimpossible task of isolating specific sexual practices in research subjects, who usually engage in more than one type of risk behavior, and rely on retrospective self-report data, which can involve recall bias and responses tainted by social desirability (for commentary on problems in sexual behavior research, see R. C. Lewontin, Sex, lies and social science, The New York Review , April 20, 1995:24-9).Subsamples of subjects engaging only in oral sex are likely to be too small to provide adequate statistical power to assess the relative risk. 2,3 Some investigators have asked subjects only about oral sex practices or have lumped oral sex together with other behaviors. 4 In addition, a myriad of uncontrolled factors-dates of infection, number of oral sex events, whether or not oral cuts or abrasions were present-prevent the clear quantification of risk. Most of these epidemiologic studies have sampled homosexual or bisexual men exclusively; accordingly, even less is known about the relative risk of oral sex in the context of lesbian or heterosexual practices.Results from epidemiologic studies have generally been interpreted as evidence against oral sex risk, relative to other behaviors. 3,[5][6][7][8] These studies are based on retrospective self-report data from questionnaires or interviews about risk behaviors over a previous time period, and are also longitudinal in that they follow initially HIV-negative men and test these men over time to see whether or not they undergo seroconversion. Laboratory stud...

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Detection of HIV-1 DNA sequences in pre-ejaculatory fluid

Cited by 63 publications

References 0 publications

Withdrawal (Coitus Interruptus) as a Sexual Risk Reduction Strategy: Perspectives from African-American Adolescents

Withdrawal (Coitus Interruptus) as a Sexual Risk Reduction Strategy: Perspectives from African-American Adolescents

Detection of Simian Immunodeficiency Virus in Semen, Urethra, and Male Reproductive Organs during Efficient Highly Active Antiretroviral Therapy

Counseling patients about HIV risk from oral sex

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