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How Safe Is Unsafe Sex?

David W. Fleming, MD; Stephen L. Cochi, MD; Richard S. Steece, MS; Harry F. Hull, MD

JAMA. 1987;258(6):785-787.

Abstract
Serum specimens from the cohort of persons who attended sexually transmitted disease clinics in New Mexico during a two-month period were tested for human immunodeficiency virus (HIV) antibody. Twenty-seven (2.0%) of 1374 serum specimens had repeatedly low-positive reactions by enzyme-linked immunosorbent assay testing, and 22 (1.6%) had repeatedly high-positive reactions. All sera (sufficient for testing by Western blot) with low-positive reactions gave negative results, and all sera (sufficient for testing by Western blot) with high-positive reactions gave positive results. All persons whose serum had high-positive reactions were male. Most (86%) had been seen at the only urban sexually transmitted disease clinic in New Mexico, and most (72%) were openly gay or bisexual. Of all gay and bisexual men evaluated, 14% (16/112) had high-positive reactions. Rapid plasma reagin positivity was significantly associated with HIV enzyme-linked immunosorbent assay low (false) positivity. The relatively high rate of HIV seropositivity among gay men with other sexually transmitted diseases indicates that transmission of acquired immunodeficiency syndrome is continuing in this low-incidence area and documents the need for testing and counseling programs in sexually transmitted disease clinics.

(JAMA 1987;258:785-787)

Author Affiliations
From the Division of Field Services, Epidemiology Program Office (Dr Fleming), and the Division of Immunization, Center for Prevention Services (Dr Cochi), Centers for Disease Control, Atlanta; the Scientific Laboratory Division, New Mexico Health and Environment Department, Albuquerque (Mr Steece); and the Office of Epidemiology, New Mexico Health and Environment Department, Santa Fe (Dr Hull). Dr Fleming is now with the Office of Health Status Monitoring, Oregon State Health Division, Portland.

Footnotes
Reprint requests to Office of Health Status Monitoring, Oregon State Health Division, 1400 SW Fifth St, Portland, OR 97201 (Dr Fleming).

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