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Nathan Clumeck, MD
St Pierre University Hospital Brussels

JAMA. 1986;255(17):2289.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Needle or sexual transmission of HTLV-III/LAV among heterosexual people is an important question that rouses passionate debate.¹ Indeed, among heterosexual Africans it has been claimed that multiuse of unsterilized medical needles used for the treatment of sexually transmitted diseases could explain the discrepancies between the epidemiology of AIDS in developing countries and that in the United States.² Accumulating epidemiologic evidence, however, argues against the "needle hypothesis" in Africa.³

From the data reported by Tirelli et al it appears quite clear that among IV drug abusers, the sharing of contaminated needles is a more efficient method of HTLV-III/LAV transmission than heterosexual contact. There is little doubt that repeated injections of contaminated material directly into the bloodstream is probably the easier way to be infected by a blood-borne virus, which will immediately encounter receptive T4 cells in the recipient host. If epidemiologic studies have shown that among . . . [Full Text PDF of this Article]

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