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What are the chances, doctor?
The risk of HIV transmission from a single sexual encounter is a popular topic of conversation between sexual healthcare providers and patients. Patel et al have recently updated the USA’ Centers for Disease Control 2005 review, in which this risk was previously estimated.1 ,2 Their review includes the most recent observational and interventional study findings, in particular those pertaining to the use of treatment as prevention (TasP). The review reports that receptive anal intercourse carries a risk of 138 transmissions per 10 000 acts (1.38%) in the absence of antiretroviral therapy (ART) or condoms, compared with 4 transmissions per 10 000 acts of insertive penile–vaginal sex (0.04%). The use of both condoms and ART reduces the risk of HIV from sexual exposure by 99.2%. With careful study of figure 2 in the paper and armed with a pocket calculator, the reader will be able to calculate many other permutations of estimated risk from the data reviewed.
The irony of TasP and Patel's review …
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