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Any
factor that can increase the amount of HIV-infected blood or sexual
fluids exchanged during sexual intercourse is a facilitating factor
and any factor that can limit the amount of infected fluids is a
protective factor.
New (incident) HIV Infections - Individuals newly infected with HIV are much more (10-20x more?)
infectious compared with individuals who have passed the acute
period.
Other STI - It is generally accepted
that other STI, especially those that cause ulcerative lesions such
as genital herpes, chancroid and syphilis, increase or facilitate
HIV transmission.
Lack of
Male Circumcision (MC) - Many epidemiological
studies have shown that male circumcision is associated with a reduced rate
of HIV acquisition. Since this hypothesis was first suggested over a decade
ago, increasing documentation to support it has accumulated and the most
recent field trials indicate that it may reduce heterosexual HIV
transmission by up to 60%.
�Dry Sex�
- In many parts of SSA and some areas of
Southeast Asia, some women apply astringent substances into their vaginas to
limit their vaginal secretions. Such
�dry sex� can be much more traumatic and cause lesions in the vagina that
can lead to an increase in HIV transmission rates.
Condom
Use - A high level of condom use can have a
major effect in reducing sexual HIV transmission.
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