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  • Title: [Transmission and prevention].
    Author: Reboulot B.
    Journal: Soins; 1992 Jan; (556):16-20. PubMed ID: 1609320.
    Abstract:
    This work provides an overview of current knowledge of AIDS transmission and attitudes toward prevention in France. Most HIV infections are transmitted sexually. AIDS became established in the homosexual community in California because of mutual infection by members of the community with large numbers of sexual partners. The possibility of heterosexual transmission was not immediately recognized by all observers. Different publications estimate the risk of seroconversion after 1 episode of heterosexual coitus at between 1:100 and 1:1000/ Heterosexual transmission is bidirectional, but male-female transmission appears easier. Factors favoring transmission identified in AFrican studies include multiple partners, sexually transmitted diseases, anal penetration, relations during menstruation, and age. No epidemiologic study has concluded that kissing with mutual salivary contact can lead to infection, but oral-genital sex may pose a risk. As of October 1991, 966 cases of posttransfusion AIDS had been diagnosed in France, and an estimated 6000-9000 HIV seropositive persons were infected through transfusion. 239 AIDS cases were reported in hemophiliacs and others with coagulation disorders. 1200 of 3500 French hemophiliacs receiving transfusions before 1985 are seropositive. The risk of developing AIDS from a transfusions in France is currently estimated at 1/250,000. HIV transmission among drug addicts results from sharing contaminated needles and syringes. The risk of infection for health workers treating those who are HIV positive appears small; only about 30 documented cases have been reported worldwide, including 3 of 10,000 cases in France. The risk that an infected mother will have a seropositive baby is estimated at 25% in France. The number of seropositive women in the world is estimated at over 3 million, with 80% in sub-Saharan Africa. As of October 1991, 16,0000-36,000 seropositive women and 1500 seropositive children were estimated to live in France. Pregnancy is seropositive women raises serious social and moral questions regarding the rights of children to life, health, and a family, all of which are threatened by maternal seropositivity. By 1991, the French population was well informed about heterosexual transmission of HIV infection, but fewer than 10% used condoms regularly. Screening of the blood supply and of potential donors has cut the risk of posttransfusion to disappear. Perinatal transmission should be the 2nd mode of HIV transmission to disappear. Convincing 1000 pregnant seropositive women not to carry their pregnancies to term would prevent 200-250 cases of AIDS.l Health workers should follow strict rules of hygiene with all patients, whether the serological status is known or not. The classic rules of asepsis should be rigorously followed. It may be that only when most of the population is personally acquainted with an HIV positive individual will prevention truly be taken seriously.
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