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New directions in AIDS transmission.

New directions in AIDS transmission

For now, stemming the spread of the AIDS virus relies on understanding who gets infected and how. Recent reports on the mode of trasmission are alternately:

* disturbing -- the first known instance of a mother infected by her child

* reassuring -- a confirmation of previous work showing that casual contact with AIDS patients is not a risk

* curious -- a possible link between clitoroidectomy and heterosexual transmission in Africa.

In the child-to-mother transmission, the boy was born with a digestive disorder that required numerous medical procedures, including a blood transfusion (done before the AIDS blood screen was available) that exposed him to the virus. The mother, a former paramedic, performed some of the procedures.

Blood samples from both mother and son have repeatedly shown the presence of AIDS antibodies, though virus cultures on both have come up negative. neither shows overt signs of the syndrome.

Since the mother did not recall ever having stuck herself with a needle, the researchers at the Centers for Disease Control (CDC) who describe the case in the Feb. 7 MORBIDITY AND MORTALITY WEEKLY REPORT suggest she got the infection through exposure to blood and body secretions and excretions. She did not wear gloves and often did not wash her hands immediately after exposure; adherence to guidelines for health care workers could have prevented transmission, the CDC researchers contend.

Previous reports have described only three health care workers infected with the AIDS virus, and nonsexual family contact has not been found to spread it (SN: 10/5/85, p.213). The data on AIDS victims' families are backed up by a report in the Feb. 6 NEW ENGLAND JOURNAL OF MEDICINE from several U.S. institutions. Of 101 people in nonsexual household contact with 39 AIDS patients, only one had evidence of the infection -- a child presumably infected around the time of birth.

But as nonsexual transmission of the virus comes to light, the heterosexual transmission of AIDS seen in Africa remains an enigma. Anthropologist Uli Linke of the University of California at Berkeley suggests in the Jan. 17 SCIENCE that the practice of clitoroidectomy may provide an explanation. Areas in Africa where part of the female genitalia is ritualistically removed correspond to the areas of the epidemic, she says. After some types of clitoroidectomy, vaginal intercourse can cause bleeding, and anal intercourse is often substituted. Either practice, notes Linke, could encourage spread of the virus.
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Author:Silberner, Joanne
Publication:Science News
Date:Feb 15, 1986
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