August 18th, 2010
12:57 PM ET

What's the probability of HIV transmission?

An HIV-positive German pop star stands accused of having unprotected sex without informing her partners about her status. She is charged with grievous bodily harm and attempted bodily harm.

The case against Nadja Benaissa, 28, former singer in the girl band No Angels, has generated much ethical and legal controversy. There are also some scientific questions.

What’s the probability of a female with HIV transmitting the virus to her male partners through unprotected sex? Is there a difference between female-to-male versus male-to-female transmission?

Girl band singer accused of infecting partner with HIV

“As with many things in clinical science, there is no black and white,” said Dr. Charles Hicks, professor of medicine at the Duke University Medical Center.

The scientific literature provides conflicting findings. Some studies report that there are big differences in virus transmission rates between females-to-males versus males-to-females. Others show that they are about equal.

Despite different findings, Hicks said, “My opinion is that it’s not enormously different—the idea that men very rarely get infected is a dangerous myth.”

“It used to be thought that it was unidirectional with very little female-to-male transmission,” said Dr. John Bartlett, professor of medicine in the division of infectious diseases at the Johns Hopkins University School of Medicine. “There is a large Uganda study that showed it was much more equal. The number that is quoted is 2-to-1; in other words, male to female is twice as efficient or more likely to transmit HIV, as female to male.”

It also depends on viral load (the amount of HIV measured in his blood), which can be suppressed by taking medication and condom use.

It’s a topic that doctors aren’t eagerly discussing, but the rate of transmitting HIV is low during heterosexual intercourse- estimates are from about 1 in 1,000 to as low as 1 in 10,000. Anal intercourse is believed to be more efficient in transmission.

Determining such probability is an inexact science. Safe sex is heavily stressed, because, Bartlett said, not doing so is “Russian roulette."

soundoff (803 Responses)
  1. under fire

    hey grace–are you sure your spouse is faithful?

    August 18, 2010 at 17:49 | Report abuse | Reply
  2. '_'

    I think its ignorant to think female can't pass HIV to males. That's Uganda thinking and an excuse to think you're safe. That's why latino males for example, go with prostitutes and then bring the infection at alarming rates in those communities. I've seen it first hand and it can happen even in caucasian social circles, hetero or homosexual.

    Its irresponsible to think, suggest it on top of ignorant and should not be used as an excuse for unprotected sex.

    The other major issue I have overall is that in Men's magazines, I'm a male, there's hardly any talk of HIV in sexual related articles. Lots of promiscuity encouraging stuff going on there. Its almost as if the articles are written with no consideration of a very real and serious health issue.

    And just this recent "vamp sex" trend in pop culture as shows in Rolling Stone magazine to me seems so crass and irresponsible.

    The messages thrown to the public are so dumb and irresponsible.

    August 18, 2010 at 17:55 | Report abuse | Reply
    • Michael

      Because "the public" aren't intelligent human beings able to make responsible choices... the "messages" from television and movies drive behavior... You should rethink people.

      August 19, 2010 at 09:16 | Report abuse |
  3. John

    Sex is serious business. It is not a play thing. That is why loyalty between sexual partners is encouraged to reduce the risk of STDs, jealousy, and unintended pregnancy.

    Anal trasmission is very high for HIV which means that if you engage in promiscious sex and are homosexual, it puts you at higher risk. (Also the risk is just as high for heterosexual women who engage in promiscious anal sex.)

    The people who are at the lowest risk for HIV transmission are lesbians (but the difference in risk is just a measly two percent in some studies).

    If I ever was going to have promiscious sex, I would request the consentor to draw his or her blood and test him or her for every STD known to humankind. If the blood work is clear, I will go for it. Such serious consequences like HIV call for serious measures.

    August 18, 2010 at 18:24 | Report abuse | Reply
    • Duce

      Dude, don't be such a hypochondriac... I understand that STDs are prevalent but it's not like everyone has one.

      August 18, 2010 at 18:33 | Report abuse |
    • Justin Case

      Don't forget, there is a "window period" for HIV. That means that someone can be infected and be able to pass on the virus to others, but still not show a positive result on a test. That is why all physicians recommend a follow up test 6 months after the first test (without any risky exposure in between) to be certain.

      August 18, 2010 at 20:48 | Report abuse |
    • Jorge

      It is to me, in fact, it has been my favorite plaything since I was 19 years old. Yet even when I was 10 I had enough common sense not to ride my minibike without a helmet, pads or shoes, just like I never chose to have unprotected sex until I got married, you know the concept, common sense?

      August 19, 2010 at 12:15 | Report abuse |
  4. Teekrul

    So Duce if you lived in Brooklyn NY you'd leave your door open at night when you go to bed? Not everyone is a murderer thief rapist etc...

    August 18, 2010 at 18:41 | Report abuse | Reply
    • Eric

      Yea, like a little lock on a door is going to stop anyone, lol. A window can be broke in 2 seconds and in the house in under 5 seconds. Foolish false sense of security.

      August 19, 2010 at 11:37 | Report abuse |
  5. Dr. Joe

    The correct answer is that it varies depending what strain of HIV the infected person has. There are several strains, some of which are more easily passed based on the genders of the people involved. HIV strains usually found in Asia have different transmissibility from women to men than those usually found in southern Africa or those usually found in North America.

    There are other factors as well such as the type of copulation, if either person has even small sores or abrasions, etc.

    But the bottom line is HIV can be passed FROM ANY gender, TO ANY gender during ANY contact where bodily fluids might mix.

    August 18, 2010 at 18:42 | Report abuse | Reply
    • jc holman

      But to put it in perspective, a man is much more likely to die in a traffic accident on the way to his date with an infected woman then he is to get the disease from her.

      August 19, 2010 at 10:57 | Report abuse |
  6. Jake

    Yes, HIV has serious consquences IF you don't know you have it, and IF you don't treat it. Today, there are many incredible meds to help people with HIV live normal healthy lives. The real issue is all the discrimination still out there associated with HIV, and that is due simply to lack of knowledge on the subject... aka ignorance. Get informed b/c we all fear the unknown. Many beautiful treatments are on the horizon that people are unaware of... anyone reading these posts and recently diagnosed then keep your head up... don't let people who know nothing about this virus tamper with your feelings.

    And to ask someone to draw blood for fear of the virus and other stds then good luck with that b/c not all viruses/stds show up in a simple blood test right away... it can take months. Use a condom... or practice abstinence if you are that fearful. I can think of many ailments out there worse than treated HIV.

    August 18, 2010 at 18:45 | Report abuse | Reply
  7. autom

    I've always wanted the wife, 2 kids, golden retriever, white picket fence, etc. But most of my exes have cheated on me; probably 80%. They were already with someone else when they dumped me or I found out. When I deployed to Iraq, it happened with probably 3/4 of the guys in my platoon. On another deployment, this married female I worked with would call home to her husband everyday saying she loves him, yet every night she was with a guy in my 8-man tent. This has all added up and led me to the conclusion that the "players" are the smart ones. I keep taking the higher path, always faithful and well intentioned in my relationships, yet I keep getting hurt. The players are happier and have a better social life than me. I don't know if I have it in my heart to ever have a one night stand or a relationship with no investment, but something tells me I'd be better off if I were a player too.

    August 18, 2010 at 19:49 | Report abuse | Reply
    • Billy

      I feel the same way, I know 3 married men that are cheating on their wives and a female who has a bf and cheated on him within a week. My ex cheated on me, she lied until she got caught, I had a strange feeling she was. Military relationships blow... lets just hope they get all the STD's and you find someone who doesn't whore it up like everyone else. (soon there will be more bi-sexual sex in females and males, it will only get worse)

      August 18, 2010 at 20:46 | Report abuse |
    • Charlie

      Women probably cheat more than men now days. (American women for sure) The editors at CNN and the other news outlets won't admit this because it is politically incorrect to portray any woman anything other than a victim. Men don't want to marry because it is not worth it. When men cheat on their wives, they lose their children, the house, and half of everything else. They deserve this when they cheat. Women cheat and receive child support, the house, and primary custody of the children. I can't tell you how many men I know that have had phony restraining orders placed on them by their ex-spouses. Until we abandon post modern feminism and recognize women for the equally flawed creatures that they are then we will continue to have the family social problems that exist in this society. (I am not talking about worthwhile goals of equal pay etc.) I am talking about the "I'm a poor little girl victim" b.s. that is thinly disguised anti male vindictive behavior.

      August 19, 2010 at 03:07 | Report abuse |
    • Harry(NJ)

      I agree with Charlie, Society is baised toward women and because of that everything else getting scewed. An independent study also showed that the majority of domestic abuse is started by the female. So what tends to happen is that women hit their husband's first and repeatly hit their husbands until they respond. http://www.law.fsu.edu/journals/lawreview/downloads/304/kelly.pdf

      August 19, 2010 at 09:22 | Report abuse |
  8. jpaulnorton

    I think HIV and STD's are a very serious issue. I also think the emotional hurt that comes from broken relationships and promiscuous relationships should be truthfully discussed. Children, Teens and adults should understand that Sex of any kind comes with consequences. Abstinence, monogomy within marriage and mature decisions could save millions. We must educate people about sex w/out bias. How to protect yourself but also how to make good decisions about waiting and being faithful men and women within our relationships.

    August 18, 2010 at 19:59 | Report abuse | Reply
  9. paging doctor gupta

    i just had unprotected sex with a street walking meth wh0re for $3. she had lots of open sores, but i still got the job done. do you think i'll be ok?

    August 18, 2010 at 20:21 | Report abuse | Reply
    • This is a serious issue

      Why are you making a joke about this? It's not funny.

      August 19, 2010 at 05:15 | Report abuse |
  10. Be An Enabler, It's fun!

    We should hand out condoms and needles to poor people. That way, they'll feel safer about sleeping with more people and doing more drugs. It doesn't matter that it won't work, what matters is that they'll FEEL safer and shut up. Because people don't want to change behavior, they just want to change the consequences. So if they feel safer, then they'll die quietly and we can go on ignoring the real causes. Be an enabler, it's fun!

    August 18, 2010 at 22:42 | Report abuse | Reply
    • Jorge

      Been there, done that, enabled myself for YEARS by having wild monkey sex in strange places with foreign women when I was young (could never do that in the U.S., too much drama involved). Loved every minute of it. Used latex condoms every time, COMMON SENSE. Here you have me 18 years later, smoking a black-market cigar and snickering at your post...

      August 19, 2010 at 12:32 | Report abuse |
    • Be An Enabler

      General Mendoza (AKA: Jorge), So this wild monkey sex you had 18 years ago, did you screw any Mexicans? Because I never met my padre. He was just some pr*ck who thought his condom was on right, but his vile sperm infiltrated by mother's hot punani. Thanks, pop.

      August 19, 2010 at 22:31 | Report abuse |
  11. Sam

    This article is a complete FAILURE. It doesn't mention the one thing that many studies have shown to be absolutely true. Circumcised males have a much lower change of getting HIV from sex with infected females than uncircumcised males. I'm confident that that guy is not circumcised, simply because most Europeans are not. Also, and very unfortunately, most sub-saharan Africans are not as well.

    August 18, 2010 at 22:46 | Report abuse | Reply
    • Curious

      False sense of security at best. And, I'm sure that if you cut the penis off entirely, the chances of catching HIV go down even more.

      August 19, 2010 at 01:12 | Report abuse |
  12. Sam

    To confirm the circumcision connection:


    I'm not arguing circumcised males are in the clear. I'm trying to point out an important point and something fundamental that seems to be missing from the discussion.

    August 18, 2010 at 22:54 | Report abuse | Reply
    • Be An Enabler, It's fun!

      You're holding CNN reporting to unrealistic standard of full disclosure. But, its an easy mistake to make. There's not a strong alternative that reports things like facts, the truth, or non-celebrity nuggets. All joking aside though, good call on that omission about circumcision!

      August 18, 2010 at 23:04 | Report abuse |
  13. Young Sinatra

    I want an instant test strip of paper. Lick it and if it turns 'GREEN' no s.t.d.'s. If it turns 'RED' run like hell!!:) We have the technology people...come on.

    August 19, 2010 at 00:48 | Report abuse | Reply
  14. This report is not very good

    First of all, this report does not provide any specific details about how female-male transmission is possible and what can be done to prevent it. Specific sexual details that are presented with scientific, objective language are needed here. If most people are to get any useful knowledge from this report, then CNN needs to use words and phrases that are informative rather than provide vague information from Ugandan reports.

    Secondly, this report still implies that homosexual contact is still more riskier than female-male transmission. But, any good junior high school health teacher can explain to students that certain heterosexual sexual practices, including anal sex between men and women as well as oral sex, or if if either person has cuts or scratches affect female-male transmission.

    CNN should be a reliable medium through which specific, objective information is broadcast, when it fails to provide this, then it is no better than a private blog.

    August 19, 2010 at 00:54 | Report abuse | Reply
  15. C

    The HIV virus is found in body fluids and is transmitted into the bloodstream through a break in the skin. This is why it is so much easier for a man to infect another man or a man to infect a woman. I know this from counseling HIV positive patients for 15 years.

    August 19, 2010 at 01:10 | Report abuse | Reply
  16. Curious

    Promiscuous people may be at increased risk of contracting HIV but they do not deserve HIV/AIDS. There's a difference.

    August 19, 2010 at 01:15 | Report abuse | Reply
  17. Charlie

    CNN, your reverse sexism is ridiculous. Of course female to male HIV transmission is possible. Aren't we constantly told that sex with female prostitutes is risking HIV infection at every sex-ed class in High School and college? This article is ignorant. It kind of reminds me of the homophobes that use to perpetuate the myth that AIDS is a gay man's disease. Stop diagnosing criminal female behavior and treat them as you would a male offender exhibiting the same behavior patterns.

    August 19, 2010 at 02:17 | Report abuse | Reply
  18. clark1b

    amazing ... one person says that lack or promiscuity and lack of drug abuse reduces the risk of HIV infection for that person .... and the hateful people jump in and blather along as if .... monogamy is the culprit for all HIV infections.

    So, what do you tell your loved ones ... go out and be promiscuous and carefree ... or do you say be careful there are ways to reduce your risk and here is the list?

    August 19, 2010 at 02:47 | Report abuse | Reply
    • Check yoour vocabulary

      "Monogamy" means staying with ONE person, so it is not a cause of HIV .

      August 19, 2010 at 04:38 | Report abuse |
  19. NURSE

    we as health care workers, have to be very careful when caring for all patients.

    August 19, 2010 at 02:56 | Report abuse | Reply
  20. me


    August 19, 2010 at 06:01 | Report abuse | Reply
  21. wmsJAX

    The singer was wrong and I know she understands that now!!! This is not an isolated incident and Grace is entitled to her opinion... However, no one deserves an incurable disease. To those quoting "reap what u sow" that's true also. Grace is sowing condemnation/judgement if she lives long enough she'll understand this a sad story. The bible states what we all deserve but fortunately, we have access to something we're "undeserving of" [God's grace] because of God's love! To those who are heavy burden or tired of life, there is answer and there is peace [of mind]. Additionally, to all the honest people (never lied), virgins and faithful spouses... (who never cheated)! Much love 2 U!!

    August 19, 2010 at 09:47 | Report abuse | Reply
  22. racnem

    In defense of Grace, it's not like people don't know what they are risking. No baby, etc. deserves AIDS or to be drug addicted, but that is the ripple effect from people that refuse to live a moral life. So who's to blame? Not GOD, he told us not to do this stuff. He gave us the solution before the problem. But no one listens.

    August 19, 2010 at 09:59 | Report abuse | Reply
  23. Mooseknuckle

    AIDS is another reason there is no god...and that list keeps getting longer

    August 19, 2010 at 10:34 | Report abuse | Reply
  24. Sherri

    he who lives in sin, shall die in sin

    August 19, 2010 at 10:46 | Report abuse | Reply
    • Boom Boom (Norfolk, Va)

      ...Sheri...and he who lives in ignorance, will continue to be dumb as a brick.

      August 19, 2010 at 11:18 | Report abuse |
    • Jorge

      Yup, but we'll have a heckuva time getting there, NANA NANA!

      August 19, 2010 at 12:37 | Report abuse |
  25. George

    She's a goddamn whore.

    August 19, 2010 at 11:00 | Report abuse | Reply
  26. doctor howard, doctor fine, doctor howard

    woo woo woo wooooooooo...nyuk nyuk nyuk

    ::smack:: ::poke::

    ::tongue out::


    August 19, 2010 at 11:24 | Report abuse | Reply
  27. ken

    People, sex is not the only way to contract a virus, including HIV. You have to be careful at all times. HIV may be harder to transmit than a cold virus, but it's not impossible. So those of you that think you are safe from just the sex angle are fooling themselves. You have to be mindful always about blood, fluids, object contact, and personal contact. Also there is no guarantee this virus won't mutate just a bit and become easier to transmit through more normal cold-like transitional methods.

    August 19, 2010 at 11:35 | Report abuse | Reply
  28. honey pie

    it's ok if you eat her lunch box

    August 19, 2010 at 11:36 | Report abuse | Reply
  29. TSJustus

    datguy: Why are you judgmental of Grace? Seems like you contradict yourself dramatically with your accuasation that SHE is judgmental, when you are very much judging her for her judgment. Get a clue, and stop being a hypocrite.

    August 19, 2010 at 12:42 | Report abuse | Reply
  30. Mike

    What Grace said was clumsy, but the point is correct. Knowing what we know, knowingly having unprotected sex and engaging in promiscuity is selfish, shortsighted, and irresponsible. While some people contract this virus through no fault of their own (cheating partner, blood transfusion, childbirth, etc) the vast majority of people who contract it could have prevented it by taking some sensible precautions, or getting control of their libido. The fact is, if the reckless cases of transmission were controlled, there would also be far fewer cases of accidnetal transmission as well, and we might just get a handle on this disease. But until people stop thinking with their genitals, this will continue to be a costly problem.

    August 19, 2010 at 12:45 | Report abuse | Reply
  31. Grace was not being clumsy

    The only thing I disagree with is when she said "you get what you deserve" .. most of the time, yes. But what if your spouse cheated on you and you had no idea and you contracted a disease that way... Hopefully you don't sleep around and if you do, then please get checked often!

    And those of you who said God is not real because of HIV, you are wrong.. and yeah go ahead and say your whitty comments because I said God is real. He is real... and we see His miracles everyday.. Sometimes you just have to have a little fait!

    August 19, 2010 at 16:43 | Report abuse | Reply
  32. Todd Sauder

    OMG! People, it's easy. If your partner cheated with someone and contracted HIV or an STD and passed it to you, you are seen as a "victim". However, if you slept with 75 people over the course of 10 years and in many cases did not use a condom and THEN contract a disease you are seen as "living by the sword, dying by the sword". It doesn't make you evil or worse than anyone else, it just makes you a person that engaged in risky sexual behaviour and, therefore, responsible for your condition. Given all the education and teaching around sexually transmitted diseases, if you catch one uner the latter scenario then there is NO EXCUSE for you. You played a risky game and got burned. Just like someone who speeds on the highway and makes aggressive lane changes...you are more likely to crash and when you do, sympathy will be in short supply.

    August 19, 2010 at 18:35 | Report abuse | Reply
    • Todd Sauder

      BTW, my girlfiriend is an incredibly WONDERFUL, sensitive, compassionate, loving, maternal woman who contracted genital herpes because one of her boyfriends did not tell her of his condition. After months of dating and using condoms he convinced her that they were monogamous and he was clean. RIGHT! Now she has herpes and I have to deal with it. Is she evil? Nope. Is she awful? Far from it. Did she fall into the trap of believing that in the space of a few months that you can trust a man to be honest wiFh his sexual history AND did she believe that sex was a prime motivation for "being good to her man" and keeping him interested? Yes...and now she and I pay the price.

      August 19, 2010 at 18:40 | Report abuse |
  33. George O'Brien

    This is an all too common problem. My friend started a website to help with this a couple years ago called STD Carriers after a woman gave him herpes, but knew about before they met and never told him until it was too late. To this its the only place where the public can anonymously post profiles of known carriers to warn others. He has a good profile on this singer too and he tells me that his AIDS crime list has just passed 100 offenders.

    August 19, 2010 at 23:14 | Report abuse | Reply
  34. GetSmarter

    This article and the doctor who gave his opinion present flawed data. In all cases, men who are NOT circumsized expose water-absorbtive tissue to the virus in either hetero or homosexual events. Anal sex always exposes water-absorbtive tissue inside the colon to the virus if it is transmitted. If a male has the virus, it's in his semen, so he can expose the partner during vaginal or anal sex. The female to male statistics are heavily dependent on whether a man is circumsized or not. Circumsized men are exposing much less of there own moist tissue to transmission. Without the whole story, the data is meaningless.

    August 20, 2010 at 11:20 | Report abuse | Reply
  35. GetSmarter

    Oh, and treating HIV differently than any other viral infection in regards to "who deserves to catch it" is the most stupid point of view to take. On any given day, each of us does something, knowingly or not, to expose ourselves to pathogens. If I eat a salad at a restaurant knowing that an ineffective washing or handling is statistically possible, do I deserve the Salmonella that I might contract? Grace is a "holier-than-thou" idiot who has missed the greater scriptural message of "thou shalt not judge."

    August 20, 2010 at 11:26 | Report abuse | Reply
  36. Elizabeth Ely

    I wrote about this case for the OMSJ Web site in 2010, at http://www.omsj.org/blogs/nadjas-choice. The charges against Nadja Benaissa were blackmail, pure and simple. This girl was not sick, and she was publicly not taking the drugs, and the AIDS establishment had to bring her back in line, back into the lie. A lot has happened since 2010. Now it's the mainstream AIDS organizations who are arguing that the odds of getting this infection through sex is incredibly low and that the "HIV criminalization" laws should be repealed! Why? Because OMSJ has defended people like Nadja by bringing in expert witnesses that testify not only to that fact but also that the "HIV test" itself is nonsense. Close to 50 criminal cases in the U.S. have been dropped, plea bargained or lost in court because of OMSJ. Food for thought, isn't it? See http://www.omsj.org/innocence-group for details. The odds of getting infected with "HIV" through various kinds of sex is reported at http://www.catie.ca/pif/summer-2012/putting-number-it-risk-exposure-hiv. Although the article starts by saying that there's really no way to design a good study of this, it nonetheless cites a view "meta-analyses" that review all the bad studies. It comes up with figures ranging from 1 in 161 to 1 in 2,500. Not exactly a "smoking gun" in a criminal case.

    March 26, 2013 at 01:23 | Report abuse | Reply
  37. Statistic

    Dirty Little Secret: How many CONFIRMED cases of female to male transmission of HIV from a SINGLE unprotected sexual encounter exist in the USA.....

    Does not apply if male has open lesions on glans........

    and the answer is NONE... Don't believe me contact CDC with the same question.

    June 6, 2013 at 18:11 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.