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Jonathan M. Mann, MD, MPH; Joseph B. McCormick, MD; James W. Curran, MD, MPH
Centers for Disease Control Atlanta

Thomas C. Quinn, MD
National Institute of Allergy and Infectious Diseases Bethesda, Md

JAMA. 1986;256(22):3091-3092.

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In Reply.—

We agree with Dr Rothman that, as stated in the discussion section of our article, our study results do not rule out the possibility of household clustering of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (human immunodeficiency virus [HIV]) infections in Zaire. However, household clustering should not be equated with transmission through casual or "household" contact if other exposures cannot be excluded. In our preliminary study, other sources of exposure could not be investigated, since nonspouses who were seropositive could not be further evaluated. Recently, it has been shown that extrafamilial nonspousal sexual transmission represents an important risk factor in African countries and that the expected background prevalence of HIV infection in over 2300 adults in Kinshasa is over 6%.^1,2 In addition, the prevalence of HIV infection in blood donors in many African countries is high, and transfusions are an important source of transmission to both adults . . . [Full Text PDF of this Article]

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