[AIDS and reproduction -- some aspects]

At present probably about 1/2 million people have AIDS in the world. About 10 million may be infected with HIV without showing symptoms. By 2000 at least 5 million new cases of AIDS are expected. In Latin America AIDS was first concentrated among urban male homosexuals. Lately AIDS has increased rapidly among heterosexuals especially among bisexuals. In Sao Paulo and Rio de Janeiro 28% of bisexuals were infected with HIV in 1987. In Rio about 1/2 of male or female prostitutes were infected. The number of partners the frequency of coitus simultaneous infection with genital ulcers and anal sex increases the chances of heterosexual transmission. 25-50% of the children of infected pregnant women are born infected with HIV. By the end of 1992 at least 1 million babies will be born to infected mothers of whom 250000 will be HIV positive. Vertical transmission from the mother to the fetus by decidual leukocytes (especially trophoblasts) via transplacental passage was verified by identifying HIV in aborted fetuses in the 2nd and 3rd trimester. HIV infection can also occur during delivery. The virus can also be transmitted via mothers milk: there have been reports of HIV in milk since 1985. The US Centers for Disease Control advised against breast feeding by HIV infected mothers. Up to 15 months of age it is difficult to assess whether HIV antibodies are derived from the mothers infection or from the infant itself. A polymerase chain reaction test could resolve this problem by amplifying the genetic chain in the blood and detecting HIV in the DNA of the child. Recent studies have indicated that there is no additional risk posed by breast feeding for those infants who have been exposed to HIV during pregnancy or delivery. Mothers infected with HIV in developing countries may breast feed their infants because it is crucial in reducing infant mortality.