Human immunodeficiency virus transmission and hemophilia.

Heterosexual transmission of human immunodeficiency virus (HIV) accounts for only a small percentage of the cases of acquired immunodeficiency syndrome in the United States, but it is a major public health care issue. However, despite intensive education and counseling regarding HIV transmission and prevention of transmission, including safe sex practices and pregnancy prevention, fewer than half of the couples in which one member is a hemophiliac practice these preventive measures consistently. Because heterosexual HIV transmission is preventable, this poor compliance is puzzling. The implementation of safe sex practices may increase the HIV-associated stress that is experienced by these couples, and the female partner may not necessarily be well informed, fearing testing and confidentiality issues in her own community. By providing education and counseling for female partners of hemophiliacs about their HIV-associated risk or by seeking alternative resources to help accomplish this task, hemophilia care providers will be fulfilling their ethical and moral obligations to these women.