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Preventing the Heterosexual Spread of AIDS:  Are We Giving Our Patients the Best Advice?

Norman Hearst, MD, MPH; Stephen B. Hulley, MD, MPH
JAMA. 1988;259(16):2428-2432. doi:10.1001/jama.1988.03720160048029.
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THE EPIDEMIC of acquired immunodeficiency syndrome (AIDS) epidemic is an unprecedented public health threat; it constitutes the leading cause of premature mortality in some areas of the United States, and it is growing rapidly.1 Until a cure is developed, the only way to control the epidemic is through prevention strategies directed at the three modes of spread of infection with the human immunodeficiency virus (HIV). Preventing spread of infection by infusion or inoculation of blood involves making blood products safe and teaching intravenous drug users how to avoid infection. Preventing the perinatal spread of infection to newborn babies involves testing prospective mothers for HIV antibodies and advising those who test positive to avoid pregnancy or, if already pregnant, to consider abortion.

In this report we consider strategies for controlling the third and most common mode of spread, sexual contact. A recent report by Friedland and Klein2 recommends educating


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