To examine whether there are any differences in the rates of HIVspousal transmission between those who have acquired the virus through blood or through sex in central China. A total of 650 HIVinfected individuals were enrolled, 420 of them were either former commercial plasma donors or recipients of blood (blood transmission group [BTG]), and 230 had acquired HIV infection through sex (sex transmission group [STG]). The spousal transmission rate of HIV was 2z per year (94/420, 11.2 years) in BTG and 8.9 z per year (115/230, 5.6 years) in STG. There was a significantly higher transmis sion rate of HIV through maletofemale (11.7 z per year, 84/128, 5.6 years) than through femaleto male (5.4 z per year, 31/102, 5.6 years, P º 0.05) in STG, but there was no significant gender based differences in BTG. In BTG, all HIV1 tested were subtype B?, while in STG, HIV1 tested were predominantly subtypes CRF01_AE or CRF07_BC. Our results show that the HIVspousal transmis sion rate was higher in STG than in BTG, and that there was a higher rate through maletofemale than femaletomale in STG.

The Chinese government has paid great attention to HIV prevention, banning all illegal plasma donation stations since 1996 and reinforcing the administration of blood donation and transfusion through legal blood and plasma donation stations. Therefore, direct HIV acqui sition through blood donation and transfusion has been under control. A recent trend is that HIV is spreading from a population with well recognized risk factors to the general population. Secondary transmission includ ing HIV transmission between couples from infections acquired through either blood/plasma donation or blood transfusion, still occur. In addition, the number of people who have multiple sex partners is on the rise in China, which also results in HIV transmission from in dividuals with high risk behavior to their spouse via sex ual relations. In light of this, the study was performed to evaluate the patterns of spousal transmission of HIV in central China.