Questioning Wawer et al.’s Estimated Rate of Sexual HIV Transmission from Persons with Early HIV Infections

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Abstract
To the Editor—Wawer et al. [1] use data from a prospective study of HIV incidence in Rakai, Uganda, to estimate rates of HIV transmission per coital act between HIV-discordant heterosexual partners, according to the stage of infection in the index partner. They use genetic testing to support intracouple transmission [1]. Their estimated rate of transmission—0.0082 transmissions/coital act—during the initial 5 months of the index partner’s incident infection depends on 23 formerly seroconcordant HIV-negative couples with incident HIV, of whom 10 (43%) were seroconcordant HIV positive when the first infection was recognized after a 10-month follow-up period