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Bruce Voeller, PhD
Topanga, Calif

Deborah J. Anderson, PhD
Harvard Medical School Boston, Mass

JAMA. 1992;267(14):1917-1918.

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

To the Editor.

—Diverse cellular and immune factors in sexual fluids and the coital environment have been postulated to influence the sexual transmission of HIV type 1.¹ The differences between male-to-female and female-to-male transmission that were documented recently by Padian et al² suggest to us that an additional coital factor, vaginal pH, could also significantly influence the sexual transmission of HIV.

Free virus and/or infected lymphocytes and macrophages (principal host cells for HIV) are thought to be the infectious unit(s) transmitted during coitus. Each can be found in semen and in vaginal secretions of HIV-infected individuals. Free virus and lymphocytes are both inactivated at low pH, as illustrated in the Figure. For free virus, inactivation occurs within minutes.³ Vaginal secretions from healthy reproductive-aged women are characteristically acidic (pH values of 3.4 to 6.0) and thus present a hostile environment for HIV particles and infected lymphocytes. For this . . . [Full Text PDF of this Article]

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