The majority of new HIV cases worldwide are the result of transmission between cohabiting couples.

Ignorantly stating something you believe isn't going to help stop the spread of HIV.

Ralph396- Abstinence hasn’t worked too well over the last millennia has it?

Only perfectly for people like me who were never exposed to any STD's, and never spread any STD's to other people, knowingly or not.

I put it into practice 2 different times in my life, and it worked perfectly both times.

Works every time it's used!

I'll make this short and easy... Ralph is right, Daniel is wrong (some guys get ever more tang). And I blame the homos. Goodnight.

If the US would learn to accept everyone for who they love and are attractted too, instead of driving them into the closet and then into high risk behaviors. We would reduce HIV in this country.

No matter where you choose to have sex (either in the closet or on the sofa) you can use protection. Gays should use protection just like straight people.

or the men they screw around with

Sure, but there's a bit of logic one has to employ (since not every new case of HIV has been epidemically characterized, and the focus has been on Africa).

First, the vast majority [~66%] of HIV infections are found in sub-Saharan Africa (http://www.avert.org/worldstats.htm).

The majority of these are heterosexual transmission cases (http://www.avert.org/women-hiv-aids.htm).

In sub-saharan African countries where this has been well studied, it is calculated that 60-94% of HIV infections occur between cohabiting couples (http://www.ncbi.nlm.nih.gov/pubmed/18586173). This data is a result of mathematical modeling using observed rates of transmission within a couple as the main input.

This finding was for two neighboring countries, but similar observations have been made for several other countries in sub-saharan Africa.

As an aside, the US is experiencing a shift toward more heterosexual transmission cases (http://www.cdc.gov/hiv/topics/surveillance/basic.htm#exposure). We should all be aware of the experiences that Africa has had with HIV/AIDS, as the things we learn from experience over there will be of help in preventing new HIV cases here.

Yes, factually correct. But nobody developed the syndrome without the virus, and the vast majority of untreated HIV infections will result in development of the syndrome. So, it is just intellectual short hand to refer to these two connected health issues synonymously.

If you have the virus in your system, there is a good chance that you will develop AIDS. If you have syndrome, then likely have the virus.

dman:

There are a few viruses other than HIV that produce Acquired Immuno Deficiency but they do not produce symptoms as severe as HIV. HIV's superior ability to target T-cell lymphocytes distinguishes it from the other viruses. Hence, having AIDS does not always means HIV infection.

In pursuit of concise scientific writing, Ethan Tyler is correct in pointing out editor Marilynn Marchione's sloppy writing. Her very first sentence is indicative of additional carelessness.

"Provocative new research shows that treating people with the AIDS virus can provide a powerful bonus: It cuts the risk that they will infect others."

It is certainly provocative new research if the AIDS virus is used to treat people and as a bonus, cuts the risk of transmission.

Being HIV+ can and often leads to AIDS, but simply having HIV doesn't mean one has AIDS. The point is there is no "AIDS virus." There is HIV (the virus), and AIDS, which is a syndrome the virus can cause.

Factually correct information doesn't need to be followed with a "but" explaining why it's ok to misstate those facts.

FatCat,

That should be read as treating people who have HIV can cut the risk that they will infect others.

This should not be confused with giving people HIV will reduce the risk that they will transmit the virus. Giving people HIV will only lead to more AIDS cases.

-ted-:

You are correct. I was referring to the need for concise writing so as to avoid ambiguity. Here, Marilynn's writing can be contrued to have two meanings. Readers expect professional writer Marilynn to proof read prior to publication.

That comment certainly makes much more sense in light of your explanation.

I agree that it is vitally important to be exquisitely clear when discussing topics such as this, otherwise people can come away with completely the wrong conclusion.

I'm not an expert on this subject, but I'm unaware of any other virus which causes the Acquired Immune Deficiency Syndrome. I know that a small number of people are born with a genetic immune deficiency. But this is not a viral condition. It is not contagious. And, I believe it is untreatable.

So, FatCatGets, what other virus (or bacteria) causes this condition?

"Provocative new research shows that treating people with the AIDS virus can provide a powerful bonus: It cuts the risk that they will infect others."

I do agree that the meaning of the above passage is, at best ambiguous, and at worst, humorously misleading. I guess the mean level of literacy in this country is declining.

Maybe you missed the point in the article (or didn't bother reading it) that 20% of people with HIV don't know they have it. If they don't know they have it, how would they know they are infecting other people.

Rock, there is a strong movement among some people wanting to get aids...some kind of badge of honor or something. Furthermore, this the me generation and the me people only care about what they can get and could careless about anyone else.

People acting irrationally and without consideration for the impact of their actions on others. Big surprise. Who'd have thought that of the human race.

But it happens and guess what? Some husbands and wives sleep around and cause the spread, even to embroys. Sorry, folks, you can't blame this on gays.

Many have "bed mates" returning from prison with HIV and hospital transmissions can pass along the disease.

<i>"Putting patients on AIDS drugs cuts the risk they will infect others, new study shows."</i>

I haven't read the article but I truly hope for more information then this! Bad lead...

Minnie,

HIV doesn't infect embryos, or embryonic cells.

It has been shown to be transmitted to children during birth, or by the mother's milk...not in utero.

BigDee - Yep and there is a big movement among a number of gays wanting to become infected with Aids. Some badge of honor syndrome...This is what happens when people let their sex organs control their lives

BigDee - That may have been true here in the United States, at least before transmission through intravenous drug use became a major factor.

But in sub-Saharan Africa, where the infection rate among young adults in some countries has approached 25%, it is predominantly a heterosexual disease.

I also dispute your assessment of Ancient Greece and Rome as predominantly homosexual societies. While it would be fair to speak of Greece as a bi-sexual society, with many men having both wives, and homosexual lovers, many of these men, such as Phillip II of Macedon (father of Alexander the Great) were also renowned for their casual amours with women.

As to Rome, I have read of some noted men, such as Julius Caesar, who were quite definitely bisexual, I've read of no such tradition as you mention in Roman life.

BTW: I'm not so sure it was the work of the Christian Church which caused homosexuality to become a taboo life-style. Among the pagan German tribes, who came to predominate over much of western Europe, homosexuality was definitely not well-tolerated. In Icelandic sagas, the suggestion that somebody was "used like a woman", was an insult and one usually washed out in blood.

BigDeee,

I'm pretty sure you can't be convinced, but here's the breakdown for HIV transmission (in the US) in the year 2007 vs the total since the US epidemic started from (http://www.cdc.gov/hiv/topics/surveillance/basic.htm#exposure):

Statistics for 2007 ONLY

Transmission Route # of Infections % of Infections

Male-to-male sexual contact 16,749 46.61%

Heterosexual contact 11,111 30.92%

Injection drug use 6,010 16.72%

Male-to-male sexual contact and injection drug use 1,664 4.63%

Other (including mother-to-child and transfusion) 401 1.12%

Cumulative Statistics

Transmission Route # of Infections % of Infections

Male-to-male sexual contact 487,695 48.32%

Heterosexual contact 176,157 17.45%

Injection drug use 255,859 25.35%

Male-to-male sexual contact and injection drug use 71,242 7.06%

Other (including mother-to-child and transfusion) 18,266 1.81%

As you can see, the percentage of heterosexual transmission in 2007 is way higher than the cumulative percentage. This says that the HIV epidemic in the US is shifting away from the almost exclusively male-to-male epidemic it was in the '80s.

This data also directly refutes this statement of yours:

"This factor has INCREASED every year for the last 20 years, unlike the risk factors for non-homosexual populations, like drug users, for example, which have steadily decreased during the same time period."

The percentage of new HIV infections that occur via male-to-male contact has been decreasing, as has the percentage of IV drug use related new infections.

Of course, given your anti-homosexual ranting leads me to believe that you come in with a pre-conceived notion that gays are responsible and won't actually look at the facts.

The statistics in the US are unusual, since most cases of HIV worldwide are amongst straights. And the demographics in the US are complex, with HIV disproportionately affecting the black community, gays and teenagers.

BigDeee is obviously a bigot and homophobe.

HIV spread prevented by treatment?

Yes, and this was actually expected. Successful HIV treatment with anti-retroviral medications dramatically decreases the amount of virus in the blood.

The amount of HIV in the blood has previously been shown to be one of the major factors in how often HIV is transmitted http://www.ncbi.nlm.nih.gov/pubmed/11323041

Taken together, the reduction of transmission following anti-retroviral treatment wasn't an unexpected result.

HIV spread prevented by treatment? What a crock!!!

That's a truly idiotic statement. Of course treatment reduces the likelihood of transmission since the virus load is reduced, and the statistics back that up. Duh.

skrekk, I thought the same thing when I read the headline. Just like going to the emergency room doctor after a severe laceration to get stiches may stop the bleeding....duh.

Does an editor ever review the high school level articles written by these writers?? My guess is no..........

"Duh" was going to be my original comment in its entirety.

Ted, it's meaningless to lump all heterosexual transmission cases together for the purpose of HIV epidemiology. The infection rates vary greatly by both gender and race. For example black women have an HIV rate about twenty times greater than white women. (And where are the HIV prevention campaigns targeting black women?)

Also, you are talking about heterosexual HIV cases as a percentage of the total. That makes analysis a little tricky. For example, if the non-heterosexual amount of HIV infections decreased, that would create an increased calculated percentage of heterosexual cases, even if heterosexual cases did not increase.

If you want to discuss trends in heterosexual HIV, then I suggest you look into year-by-year numbers for specific demographic groups, white men, black men, white women, black women, etc. The only meaningful percentages are infection rates as a percent of population.

Oh my god, not another HIV-AIDS denialist!

Since you are not going to follow up I won't take the time to completely debunk you.

I'll simply point others to http://www.aidstruth.org/denialism/myths

I changed my mind about the followup. So the best apposing argument is to call me some clever name. Imagine... me, a "denialist." I'll have to try that one on for a while and see how it fits. Here is some information about AidsTruth and the doctors who support the site:

http://aras.ab.ca/articles/popular/200805-Broxmeyer-AIDSTruth.html

Every realm of science has its fringe element including AIDS research and climatology, but the peer review process takes care of the kooks.

Thanks for sticking around...guess I'll respond in full.

The cause of AIDS in not HIV.

I would point you to the Durban Declaration: www.un.org/WCAR/durban.pdf

This declaration states, in part:

The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous, meeting the highest standards of science. The data fulfil exactly the
same criteria [Koch's postulates] as for other viral diseases, such as polio, measles and smallpox:

-Patients with acquired immune deficiency syndrome, regardless of where they live, are infected with HIV.

- If not treated, most people with HIV infection show signs of AIDS within 5–10 years. HIV infection is identified in blood by detecting antibodies, gene sequences or viral isolation. These tests are as reliable as any used for detecting other virus infections.

- People who receive HIV-contaminated blood or blood products develop AIDS, whereas those who receive untainted or screened blood do not.

- Most children who develop AIDS are born to HIV-infected mothers. The higher the viral load in the mother, the greater the risk of the child becoming infected.

- In the laboratory, HIV infects the exact type of white blood cell (CD4 lymphocytes) that becomes depleted in people with AIDS.

- Drugs that block HIV replication in the test tube also reduce virus load in people and delay progression to AIDS. Where available, treatment has reduced AIDS mortality by more than 80%.

- Monkeys inoculated with cloned SIV DNA become infected and develop AIDS.

... HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives.

This declaration is not the result of some kook, or a vast government conspiracy, or whatever else you may happen to believe...As explained in the accompanying editorial in Nature:

"The “Durban Declaration”...been signed by scientists, doctors and senior representatives of all the world’s leading medical and scientific research organizations and government authorities engaged in HIV/AIDS research or policy — UNAIDS, medical research institutes, leading universities and independent research foundations. But, crucially, the declaration is also supported by health ministers, AIDS experts and public-health officials from countries in Africa, Asia and elsewhere in the developing world."

Furthermore, you state:

AIDS is most often caused by chronic use of drugs that are end chain terminators.

How do you explain the fact that people were dying of AIDS before any anti-retrovirals were developed or in use?

Finally you claim:

All of the antiviral medications prescribed to "HIV+" patients are end chain terminators and they are killing innocent people.

To which I would respond that while DNA chain terminators (or nucleoside analogs as they are called) may have been exclusively used 10+ years ago, this is no longer the case. Now, we have several classes of anti-retroviral drugs:

Nucleoside reverse transcriptase inhibitors (NRTIs)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Protease Inhibitors

Integrase Inhibitors

Entry Inhibitors

Again of these, only nucleoside analogs are chain terminating compounds. All of the others were designed to target a particular protein only produced by HIV.

I would also like to mention that nusleoside analogs used for HIV are preferentially incorporated by HIV's reverse transcriptase enzyme, not your body's DNA polymerase enzymes...hence the reason they're approved for use in HIV treatment. If they had no preference, they would be in use as cancer chemotherapy drugs instead (or additionally).

Very nice reply.

I would like to start off by mentioning that the Durban Declaration is a 62 page declaration and less than one page addresses the AIDS catastrophe. It covers a very wide spectrum of topics around human rights with a focus on education. I would put my signature on it because I agree with the document in essence even though I don't agree with one point.

To say that "a few vocal people" disagree with the traditional HIV/AIDS theory is disingenuous to say the least. Here is a list of 2,715 professionals who have serious doubts about the traditional HIV/AIDS correlation.

http://aras.ab.ca/rethinkers.php

In response to why AIDS existed before nucleoside analogs: My personal belief is that AIDS, like many infectious disease is generally the result of malnutrition. I tend to believe in the "it's not the germ, it's the terrain" concept for most situations. We know that chronic vitamin and mineral deficiencies lead to all kinds of problems. Then you add chemotherapy to a compromised cell balance and things get ugly. HIV may have a contributing factor but I don't believe it is primary. There are plenty of AIDS cases with no HIV involvement.

To be honest with you I may be entirely wrong... but I'm willing to admit it and when I see evidence I will honor it and change my position.

This is actually a very old debate that I'm tired of talking about. The evidence is staggering when you look at populations like Japan with high HIV rates and very few AIDS deaths. There is also the 2006 JAMA. Rodriguez et. al., Clifford Lane et. al. articles that are both odd and informative. I'm not trying to make any sweeping statements about anyone's intentions but there is a very real issue here that needs to be addressed. The nutritional component of this problem is not being adequately addressed by administering drugs alone. We will not see a healthy population until this is addressed.

A friend of mine in school used to say: "Practice does not make perfect. Perfect practice makes perfect." We can't keep doing the same thing we have done for the past 30 years and expect a different outcome. Perhaps Einstein would call this "perfect insanity."

Thanks again for the reply. Have a good night.

8vio,

Good catch on the Durban Declaration, I mucked up the link-out. Here's the real declaration: http://www.nature.com/nature/journal/v406/n6791/full/406015a0.html

You do realize that the list that you link to consists mainly of people not either medical doctors or people studying HIV, don't you? Personally, I'd rather not have my medical decisions made by engineers, counselors and the like...

The Rodriguez study you cite attempts to correlate plasma HIV levels with disease progression (as measured by CD4+ cell decline). They found a correlation, but it was not nearly as strong as was expected.

The other "article" you mention is a comment on the Rodriguez article, the first two sentences of which are:

The clinical syndrome of AIDS is due to infection with human immunodeficiency virus (HIV), which causes a progressive immunodeficiency characterized by the loss of CD4 T lymphocytes coupled with an immunosuppression related to global activation of the immune system. Since the seminal article by Mellors et al in 1996, it has been known that as a group, individuals with a higher HIV viral load tend to progress to AIDS and death at a more rapid rate than those with lower viral loads, and that different prognostic information can be derived from the CD4 cell count and the viral load.

Current research suggests that the best predictor of disease progression is the immune activation a person experiences during HIV infection. This has been solidly studied in humans and also non-human primate models.

One of the earlier publications on this subject is entitled "Immune activation set point during early HIV infection predicts subsequent CD4+ T-cell changes independent of viral load". http://www.ncbi.nlm.nih.gov/pubmed/15117761

This work was cited in the Rodriguez article, and on this point the authors of the Rodriguez article write:

In humans, the predictive value of immune activation level on HIV disease course, independent of plasma HIV RNA levels, can be demonstrated even when measured during early infection or before actual seroconversion. Thus, immune activation may be a major determinant of T-cell turnover and CD4 cell depletion in chronic HIV infection both in humans and animal hosts. Our results provide further support for additional studies exploring the relative contribution of immune activation to the pathogenesis of immune deterioration in treatment-naive, HIV-infected persons.

Finally, many of the authors of the two articles you cite are actually signatories to the Durban Declaration.

Okay... this is getting childish.

From the first page of the 100+ page link I sent you, is a list of professionals who are all working in fields that contribute to solving the AIDS problem. They are Medical Doctors, PhD professors in immunology, microbiology, public health, and Naturopathic Physicians.

Lying about the content I have provided does nothing more than weaken your position. Personally, I want a diverse perspective from molecular biologists, geneticists, immunologists, naturopathic physicians and medical physicians.

But since you like Medical Doctors there just happen to be at least 10 on the first page.

Here you go...

Jeanette S. Abel. MD, Portland, Oregon.

Dr. Richard Ablin. PhD. Immunologist. State University of New York.

Dr. Marie Adams. ND, Bastyr University, Seattle, Washington.

Dr. PAK Addy. PhD, head of clinical microbiology at the University of Science and Technology in Kumasi, Ghana

Dr. ‘Ayo Adeboye. Physician, Nigeria.

Karin Wiedmer Aebersold. Homeopathic doctor, Hefenhofen, Switzerland

Dr. Madhu Agarwal. Homeopathic physician, Nagpur, India.

Naseer Ahmad. MD, MA, DSc, Toronto, Canada. Author, The Man From Atlan (1974).

Syed Masud Ahmed. Physician, MBBS, MPH, Senior Medical Officer, Research and Evaluation Division, BRAC Centre, Dhaka, Bangladesh

Dr. Hyung Jun Ahn. Seoul, South Korea

Dr Yele Akinrolabu. Lagos, Nigeria

Shreepad Akolkar. MD, DPH (Dipl Public Health), FRIPHH, Pune, Maharashtra, India

Alejandro Alagon Cano. MD, PhD, Researcher, Departamento de Medicina Molecular y Bioprocesos, El Instituto de Biotecnología UNAM, Universidad Nacional Autónoma de México

Kiason Albaxter. PhD, Georgetown School of Public Policy Studies

Mirco Alberti. Naturopathic Physician, Bologna, Italy

Hansueli Albonico. MD, Langnau, Switzerland

Gloria Margarita Alcaraz López. PhD, Professor of Public Health and Nutrition, Universidad de Antioquia, Medellín, Colombia

Helman Alfonso. MD, Director of Research, Universidad Metropolitana Barranquilla, Colombia; Author, in Spanish, The Great Fiasco: AIDS

Serafino Amoroso. ND, PhD, DAHom, New Jersey Center for the Healing Arts, Red Bank, New Jersey

Emmanuel Anastasopoulos. MD, PhD, Athens, Greece

John B. Andelin. MD, Mercy Hospital, Williston, North Dakota

Frank Anders. MD (Retired). Colonel, US Army Medical Corps (Retired)

the rate of HIV infection is INCREASING among homosexuals, and ONLY homosexuals.

This is factually wrong! See above (in response to your last post)...

Continuing to post this isn't making it anymore truthful....

OK, and do you know who has the LOWEST HIV rate in the entire country? Lesbians.

None of these statistics have any bearing on how HIV cases should be treated. HIV rates are higher among gay men in the U.S. because HIV started among gay men in the U.S., and most of who gay people have sexual contact with is other gay people.

In Africa, more straight men and women have HIV. Same principle.

In any case, in the U.S. the balance is shifting and a higher proportion of heterosexuals are infected relative to gay men. It doesn't really change our approach; it's just a statistic.

The answer is still more counseling and support or HIV+ persons so they will stay healthy and avoid spreading HIV.

Well, that premise would be false, because sex is not the only way to get HIV, and because it is possible to get HIV from a person you are in a committed relationship with.

Matt, gimmeabreakoradrink is actually right in the sense that if most people practiced monogamy or serial monogamy (single sexual partner for years at a time), there would be a lot fewer HIV infections. If gay men practiced serial monogamy in the 1970s and later, there probably wouldn't have been a gay HIV/AIDS epidemic. (The rate of multiple sexual partners is more important than the kind of sex--anal or vaginal--in determining how rapidly HIV spreads.) He or she is also right in the sense that while you can still get HIV in a committed monogamous relationship, you are safer in that context than if you have multiple sexual partners. The safest situation would be for a couple to hold off on sex until they get tested for HIV (waiting long enough to be sure negative test results really are negative), then get married (stay monogamous permanently). This is especially true for gay men, because the prevalence of HIV is so high in the gay community.

Stop having multiple partners, I could not have said it better my self. It is true that there are other ways to get HIV besides sexual contact, I would have to say that sexual contact probably counts for a strong percentage of HIV cases. I dont have any research or articles to post, but I would argue the fact with anyone. Glyptodont great point "having one partner is not just for straight people, it should be for gay people as well. Condoms are cheap use them and avoid just sleeping around.

If there was some ignorance control...

Ted i dont believe my tax $ should have to pay for meds to help someone live longer because of the dangerous lifestyle the have (chosen).

Rich,

In that spirit, I don't believe that the ignorant should breath my oxygen...

Make that *should not*...

Braveheart, you do realize that you can get HIV other than by anal sex, don't you?

Also, you should realize that that people other than homosexuals are infected by HIV.

(Please see some of my comments above for facts/statistics on these points...)

Although, I do agree...people should wear condoms while having sex.

Here is the bottom line - In 1995 the Average AIDs person had sex with over 390 people. Life requires discipline and apparently most people nowadays lack the fortitude to act as decent and responsible humans. Keep your pants on and act like a human and you will be good to go.

Braveheart, you do realize that you can get HIV other than by anal sex, don't you?

Yup, I do....but as you know.....that is #1.

Also, you should realize that that people other than homosexuals are infected by HIV.

Yup, but typically affiliated with a partner who has had sexual contact with a homosexual or IV user, either directly or indirectly....The path almost always leads to "boys in butts". Sorry.

The world has been paying for this BS for decades now.....and its only due to the fine work of BIG PHARMA, that help has been provided.....and the overwhelming majority of the treatment is from the PRIVATE SECTOR....Not Government.

So.....I say, save the Gays, and dump obamas HC reform........keep the competitive element alive in drug research.......

Braveheart,

Please read some of my (and others') comments above. To suggest that the main route of HIV transmission is through anal sex is just not accurate. In the US the majority of infected people are gay men, but the US only accounts for 1.4 million HIV infections out of 33 million world wide. In the rest of the world this is predominantly a heterosexual disease.

Also, you and the commenter above (Rich) ought to get your conspiracy theories straight. Either our tax dollars are funding treatment or the "private sector" is. (And what does the new health care bill have to do with this anyways?)

The tax dollars are real....and for research, support, and a host of bureaucratic nonsense.....My understanding is that the Private Sectory, actually has delivered on the meds.....Why should there be both? Isn't that redundant?

Your understand would be wrong.

With a couple of exceptions, the antiretroviral compounds used to treat HIV were developed using your tax dollars.

Most of the original compounds (including AZT) were discovered at the National Cancer Institute (a part of the National Institutes of Health [NIH]) - a government institution. Many of the later compounds were developed using grants mainly from the NIH (some funding was from private non-profits as well as industry).

Even the compounds that were developed by industry (protease inhibitors and integrase inhibitors) would have never have been possible if previous government funded research hadn't first provided the structure and activity of the viral proteins that these compounds target.

Pharmaceutical companies have actually stood in the way of treating infected people in developing countries by attempting to block mass manufacturing of cheap antiviral compounds by overseas governments (which they did because Pharma wouldn't sell the drugs to them at a discount).

I'm not trying to imply that the pharmaceutical companies play no role in the fight against HIV (and other diseases), but suggesting that ONLY they should do research is nonsense.

In skrekk's defense, this wasn't an unanticipated result.

As I pointed out in another comment, we know that antiretroviral treatment can dramatically reduce HIV levels in the blood, and that these levels correlate well with transmission rate...most researchers surmised from this that treatment would reduce transmission, this was however teh first study to back up the intuitive conclusion of the other results.

Additionally, others have used mathematical modeling to suggest that treating all HIV infected people with antiretrovirals could theoretically stop the pandemic. (Though, even the authors of that study recognize the difference with what is possible and what would happen in the real world...)

The "duh" was in reference to the epidemiology, where we know that reducing transmissibility reduces the infection rate.

This may be hard to believe, but people who are HIV+ do in fact have sex, sometimes even unprotected sex. Many times this happens because they are unaware of their HIV status, other times it's due to poor decision making, some people even do it willfully - with malice.

People are fallible, especially when it comes to decisions surrounding sex.