D.K.Yuryev's homepage

Whether Sex Between HIV-positives is perilous?

D.K.Yuryev

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 they 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. 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 than among the rest of population.

Of course, this problem deserves more definite investigation which seems to be not difficult to perform having access to appropriate statistics.