March 30, 2000


              Criticized Research Quantifies the Risk of AIDS
              Infection


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              Health: The AIDS Epidemic
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              By REUTERS

BOSTON, March 29 -- A study of more than 15,000 people in Uganda that
has raised ethical questions about AIDS research in poor countries
concluded that the risk of spreading AIDS through heterosexual sex
rose and fell with the amount of virus in the blood.

The study, in Thursday's issue of The New England Journal of
Medicine, also confirmed earlier research suggesting that
circumcision guarded against the spread of H.I.V., the virus that
causes AIDS.

The research was controversial, not because of its conclusions, but
because of its methodology.

Unlike studies of H.I.V. in developed countries, the volunteers in
the Uganda study were not offered treatment, nor did doctors inform
the healthy spouse of an infected person that his or her partner
harbored the virus.

Instead, the team led by Dr. Thomas Quinn of the National Institute
of Allergy and Infectious Diseases, tested the volunteers and tracked
the spread of their illness.

Marcia Angell, editor of the journal, said she was bothered by the
methods, but acknowledged that experts were divided over whether it
was ethical to deny treatment to people in poor countries, even if
they would not normally be receiving the latest in care.

Dr. Angell and other medical experts fear that researchers will
prefer to do AIDS research in poor countries because it is cheaper
and enounters fewer logistical hurdles. She said the journal decided
to publish the Quinn study because the findings were significant and
the ethical questions still a matter of debate.

Focusing on 415 couples in which only one person was infected with
H.I.V., Dr. Quinn and his colleagues found that the disease was not
spread when the infected partner had fewer than 1,500 copies of the
virus in every milliliter of blood.

But Dr. Quinn said that "with every tenfold rise in the concentration
of H.I.V. in the bloodstream, transmission more than doubled."

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