Unfortunately, this proportion remains Heterosexual youths appear at high risk for HIV based on reports of low rates of condom use and HIV-related beliefs and attitudes. Having sex without using an HIV prevention strategy. It has been estimated that more than 40% of HIV-positive young MSM are involved in risky sexual behaviour, despite their awareness of their infection [ 26, 27 ]. 26,27. Aug 31, 2023 · There are more than twice as many MSM living with HIV in the United States than heterosexuals (678,900 versus 304,800). Data on types of sexual transmission of HIV are mounting, in aggregate suggestive of a marked heterogeneity in infectivity and possibly susceptibility between individuals. Because HIV seroprevalence is greater in men, a woman is more likely than a man to have an infected heterosexual partner. Epidemiological evidence suggests Jan 22, 1985 · Studies are trying to determine if bisexual or anal-genital heterosexual practices are more common in Africa, where contraceptives are not widely available, and, if so, whether those practices The Human Rights Campaign reports on news, events and resources of the Human Rights Campaign Foundation that are of interest to the general public and further our common mission to support the LGBTQ+ community. There are emerging signs that this epidemiological landscape may be Men overall accounted for 76% of all adults and adolescents living with HIV infection at the end of 2010 in the United States, and 80% (38,000) of the estimated 47,500 new HIV infections. RESULTS--Overall, 19 (12%) male partners and 82 (20%) female partners were infected with HIV, suggesting that male to female transmission is 1. 8% in men) not to share their HIV status Jul 18, 2018 · Men with same-sex sexual partners are 28 times more likely to contract HIV than their heterosexual counterparts despite a radical reduction in new infections among gay men in Western countries, a IDU partnerships were significantly more common among women and those with higher levels of unprotected sex and drug and alcohol use. Women are more likely than men to get HIV during vaginal sex because: The vagina has a larger surface area (compared with the penis) that can be exposed to HIV-infected semen. The rate among 25 to 34 year olds went up 42%. HIV infection) are much more common in comparison with the mainly heterosexual general Abstract. Conclusion: The present study identified gaps in rates of HIV testing among heterosexuals at high risk for HIV, and both common and gender-specific facilitators of HIV testing. Infection with the AIDS virus is increasingly documented Jan 3, 2023 · The Centers for Disease Control and Prevention (CDC) reports that in 2020, people who reported having heterosexual contact accounted for 22% of the 30,635 new HIV diagnoses that year. Within that Jul 13, 2023 · Human immunodeficiency virus (HIV) is an infection that attacks the body’s immune system. The rate among 35 to 44 There is evidence that heterosexuals living with HIV face additional challenges which may affect their clinical care. HIV is most commonly transmitted through anal and vaginal sex and the sharing of drug injection equipment. Considerably more heterosexuals engage in the act than do homosexual and bisexual men, not all of whom participate in anal coitus. Get the latest data on HIV by race and May 10, 2015 · Background Over 50,000 individuals become infected with HIV annually in the U. Jul 21, 2015 · The HPTN 052 trial was designed to evaluate whether antiretroviral therapy reduces sexual transmission of HIV. Of critical importance, is reaching young gay and bisexual men of color with prevention information and access to care. In this sample, significantly more men than women reported having HAI in the past year (35% vs. K. 32 Heterosexual transmission accounts for a greater share Apr 26, 2020 · The picture in the rest of sub-Saharan Africa is nearly as dire. Results from this study support prior research findings that GLB youth are at a greater risk for mental and sexual health problems than heterosexual youth. Since then, sexual minorities, including lesbian, gay, bisexual, and transgender (LGBT) groups have been considered among the most vulnerable populations to HIV across nations (Gangamma et al. 76, p=0. In contrast, in the U. Some exposures to HIV carry a much higher risk of transmission than other exposures. While either partner can contract HIV during vaginal sex, the tissues that line the female reproductive tract are much more delicate than penile skin, and semen is in contact with those tissues for long periods of time after intercourse. This makes it easier to get sick with diseases like tuberculosis, infections and some cancers. , cases attributable to heterosexual contact) and the heterosexual population size estimates for the denominators. , 2008; Deol and Heath-Toby, 2009; Beyrer et See full list on hiv. 005). Across the 20 cities the prevalence among women varied from 20% to 42% (χ 2 = 18. 89) with 4-point response ranging from “strongly disagree” to “strongly agree. 9 (95% confidence interval 1. David explains what’s behind the higher rates of HIV among gay men. It is a 24-item scale (α = 0. 26 A previous model assessing the UK HIV Mar 8, 2024 · The Positive Voices survey 2022, which was completed by 4,618 people living with diagnosed HIV, found it was more common for women (14. g. Black/African American people and Hispanic/Latino people are particularly affected by HIV, making up more than half (70%) of estimated new HIV infections in 2022. The risk of getting HIV varies widely depending on the type of exposure or behavior (such as sharing needles or having sex without a condom). Dr. There are also a number of MSM who have sex with women, mostly unprotected, which can transmit HIV to their female sexual partners and even to the next generation. The number of new infections among MSM was nearly four times that of heterosexuals (24,933 versus 4,350). 38% (one in 72 chance) and 0. Specifically, female sex workers and male clients are at high risk for infection and have been Jun 10, 2022 · The LGBTQ+ community remains at heightened risk of contracting HIV because of this discrimination. Nearly 1 million people (. Reviewer #2: 1. This is out of 103,700 people in total, and compared with 54,100 people who contracted the disease through heterosexual sex. Examples of less common routes of transmission include oral sex and Oct 16, 2012 · The result is that in the post-HAART era, MSM still remain the group most at risk of acquiring HIV, with substantial evidence for continuing HIV transmission. Sep 28, 2021 · HIV is more common than average in men who have sex with men (MSM). HIV targets the body’s white blood cells, weakening the immune system. Oct 19, 2023 · A late diagnosis was much more common for both men and women who probably acquired HIV through heterosexual sex, with men having an even higher percentage (58%) than women (54%). From 2015 to 2019, the number of estimated HIV infections among gay and bisexual men in the United States decreased from 26,900 to 24,500. Bisexuals in our study were more likely than were heterosexuals to report 30-day tension or worry, sadness, and illegal drug use; current smoking; and prior-year suicidal ideation. Apr 8, 2016 · INTRODUCTION. Jul 6, 2022 · HIV prevalence not only describes a geographic population, such as the city of San Francisco or sub-Saharan Africa, but also groups with defined characteristics, like men who have sex with men (MSM) or people between the ages of 18 and 24. 6%) compared to those with no IDU partners (4. The dynamic change in HIV subtype distribution presents future challenges for diagnosis, treatment and vaccine design and development. 69% of men living with HIV were gay, bisexual, and other men who have sex with men. Each couple included one partner with HIV The proportion with an income less than $5,000 varied from 18% in Chicago to 49% in Puerto Rico. 1 to 3. In this article we review the current state of knowledge of heterosexual anal intercourse practice worldwide and identify the information required to assess its Between the two time periods, HIV-positive and HIV-negative men became more similar in the following areas: paid employment, sexual identity, number of male sex partners, the likelihood of having a regular male partner and having a seroconcordant regular male partner. However, gay and bisexual men accounted for 70% of the total 34,800 estimated new HIV infections Apr 20, 2018 · Background Annual HIV testing is recommended for populations at-risk for HIV in the United States, including heterosexuals geographically connected to urban high-risk areas (HRA) with elevated rates of HIV prevalence and poverty, who are primarily African American/Black or Hispanic. Urethritis / epidemiology. Overall, homosexual men were significantly (p < 0. VL test results are within 6 months of diagnosis of HIV infection during 2021. 0% tested positive for HIV. Anal intercourse carries an AIDS risk for women greater than that for vaginal coitus, just as receptive anal intercourse carries a very high risk for males. , 2013) and that existing HIV services are more tailored to gay men (Antoniou et al. Aug 29, 2022 · Women overall are more than twice as likely to get HIV through heterosexual sex than their male counterparts. Data are based on residence at time of diagnosis of HIV infection. Being exposed to Nov 2, 2019 · Findings. One reason some groups and areas have been more affected by HIV/AIDS than others is because the HIV prevalence – the percent of the population that has HIV – is already high. A meta-analysis of studies of heterosexual HIV transmission found that, in high-income countries prior to the introduction of combination therapy, the risk per sexual act was 0. Semen can stay in your vagina for several days after sex. Work to understand and address these differences is needed. HIV testing fell among all people during the fund, research and provide HIV services for heterosexual men, perhaps due to the focus on the mode of transmission and reluctance to acknowledge men’s own heterosexual identity. Results: Over the 6 years there were 33 681 HIV tests performed on men, of which 17 958 tests were for heterosexual men. The characteristics of sexual networks especially determine the extent and rate of spread. 04% per act or, in theory, about 4 cases of HIV transmission per every 10,000 acts of vaginal sex with a woman who is HIV positive) and male-to-female (. In 2019, 65 percent of new HIV diagnoses were in gay men, bisexual men, or other MSM, per the CDC. However, the use of HIV medicines and other strategies have helped lower the risk of perinatal transmission of HIV to less than 1% in the United States. From these heterosexual men, nine tested positive for the Two types of HIV have been characterized: HIV-1 and HIV-2. S. 3) times more effective than female to male transmission. 3%) identify as transgender in the United States (US), and transgender people made up 2% (671) of new HIV diagnoses in the US and dependent areas in 2019. 5% reported sexual contact with an HBV-infected person, and 12 HIV-specific social support (Darbes & Lewis, 2005). HIV infection rates range from around 6 percent in Uganda to 39 percent in Swaziland. Studies of heterosexual HIV transmission have consistently found anal intercourse to be a highly predictive risk factor for seroconversion. e. ; Black women experienced nearly twice as many new HIV infections in 2019 as their Black male counterparts (3. In Africa HIV has always been a predominately heterosexual infection. National HIV infection rates among heterosexuals were calculated using HIV surveillance data in the numerators (i. The number of new diagnoses among gay and bisexual men fell from 1,500 in 2019 to 890 in 2020 Sep 20, 2021 · The analysis included all HIV diagnoses attributed to heterosexual transmission in 2018 in the United States, in 50 states and the District of Columbia. For some exposures, while transmission is biologically possible, the risk is so low that it is not Mar 23, 2022 · The scientists found that HIV-1 infections are more virulent in heterosexual individuals than in men who have sex with men. In Australia, unlike much of the rest of the world, HIV transmission through heterosexual contact remains a relatively rare occurrence. 001) more likely than heterosexual men to have</p> …. Further, there are racial/ethnic disparities in undiagnosed HIV and engagement in care, with Jul 27, 2015 · We applied the proportion of heterosexual persons to census data to produce population size estimates. AIDS has killed Zulu nurses in South Africa, Masai teachers in Tanzania, Kikuyu housewives in Kenya, Pygmy elders in Uganda. 08% per act or 8 cases of HIV transmission per every 10,000 acts of vaginal sex with a man who is HIV positive) transmission estimates in high Feb 8, 2024 · Note. The purpose of this article is to evaluate the prevalence of heterosexual behaviors in Sep 27, 2011 · This campaign is the latest phase of CDC’s five-year, multi-faceted communication campaign, Act Against AIDS. Gay men are 28 times more likely to contract HIV than heterosexual men and transgender women are 14 times more likely to contract HIV than other adult women. HIV Risk Behaviors. Heterosexual men are affected by HIV. Women continue to bear the brunt of the epidemic with young women infected almost ten years earlier compared to their male counterparts. Yet most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex Apr 12, 2022 · Late last year, United Kingdom health officials released data that raised eyebrows worldwide: In 2020, more heterosexuals (49%) than gay or bisexual men (45%) were diagnosed with HIV—the first Aug 2, 2012 · Methods. 6%). One hundred and one articles were included, covering 129,780 PLHIV with 478,830 patients who developed AHD. 08% when the male partner was HIV positive and the female partner HIV HIV testing was more common among sexual minorities in our study, a pattern that has been noted among sexual minority men in other probability samples. In 2022, people reporting heterosexual contact accounted for 22% (7,000) of the 31,800 estimated new HIV infections. HIV-1 is more virulent and more infective than HIV-2, and is the cause of the majority of HIV infections globally. Jul 15, 2021 · Calculations were performed for three different scenarios, each using a different cut-off for HIV-1 subtypes eligible for inclusion in vaccines for each country: (1) Vaccinating against only the most common subtype circulating in each country (“most common subtype” scenario), (2) Vaccinating against subtypes with a prevalence of >5% in The authors found that, overall, female-to-male (. Southern Africa remains the region most severely affected by the epidemic. Now scientists have found a clue to why this disparity exists. 11% (one in 909 chance) for the receptive and insertive partners respectively. The individual client files of all heterosexual men who tested HIV-positive were reviewed to determine their risks for HIV at the time that the HIV test was ordered. 70, p=0. Recent data suggest that most heterosexually acquired HIV cases in the United States can be directly linked to a sex partner who is either an injection drug user or an MSM, and these bridging relationships have been important in generating and sustaining heterosexual HIV epidemics in developed nations. 04% if the female partner was HIV positive and the male partner was HIV negative. GLB youth reported more internalizing symptoms, depression, and suicide attempts than heterosexual youth. According to recent estimates, HIV infections among young, black MSM (aged 13 to 29) increased by 48 percent from Jul 10, 2014 · People in heterosexual relationships are about 20 times less likely to pass HIV to their partners than homosexual men. The two groups diverged in these areas: age, ethnicity, educational level Jun 16, 2022 · Learn more about HIV and injection drug use. <p>This study compared prevalence rates of most common sexually transmitted diseases (STD) in heterosexual and homosexual men who made respectively 12,201 and 5324 visits to an STD clinic over 18 months. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV), or Apr 27, 2016 · Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The chance of contracting HIV via one Feb 10, 2022 · According to the U. The risk was 0. The findings could influence intervention strategies and advance our Sep 19, 2023 · HIV can also be contracted from the vaginal fluid and blood through the opening of the penis, the foreskin, and small cuts and scratches or open sores. Among couples where the man is positive, in some places individuals appear Apr 27, 2016 · Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment. [3] For example, for the past five years there have been more new HIV cases from heterosexual transmission than from Mar 28, 2024 · At a glance. Heterosexual anal intercourse confers a much greater risk of HIV transmission than vaginal intercourse, yet its contribution to heterosexual HIV epidemics has been under researched. A VL test result of <200 copies/mL indicates HIV viral suppression. In consequence, HIV-prevention efforts have been firmly focused on male-to-male sex as the most frequent source of HIV transmission. 5%) and injecting drug use (3. HIV prevalence was higher (p = 0. 1,646 respectively). Viral STIs including herpes simplex virus type 1 and 2 (HSV-1 and HSV-2) and human papillomavirus (HPV) occur in WSW. Findings suggest a number of avenues for increasing HIV The lack of sexual transmission of HIV by virally suppressed individuals in this large study provides robust evidence that antiretroviral therapy started at any time in the course of infection can prevent heterosexual HIV transmission if viral suppression is achieved and maintained, the investigators note. 3. Logistic regression models estimated the probability of past-year heterosexual activity among adults in three national health surveys, by sex, age group, race and ethnicity, education category May 20, 2024 · It’s more common for women to get HIV than men during heterosexual intercourse. Dec 15, 2011 · More common is the potential for WSW to acquire HIV through other modes, including injection drug use and sexual contact with high-risk male partners . Such numbers are astronomical compared with most of the world. This high percentage of all men who have male-to-male sexual contact and have HIV means that, as a group, they have a greater likelihood of being exposed to HIV. True. Overall, 7. Of the 798 heterosexual people diagnosed with HIV in England in 2021, 37% were of Black African ethnicity. Men reporting heterosexual contact accounted for 7% (2,100) of estimated new HIV infections. 07) for participants with IDU partners (9. 30%, χ 2 = 7. Sep 1, 2021 · Heterosexual people from black, Asian and minority ethnic (BAME) groups presented with lower CD4+ cell counts, spent less time engaged-in-care and were more likely to experience viral rebound than white people. , heterosexual cases make up only 4% of all cases, and in Europe only 6%. The lower infectivity Feb 8, 2023 · 1. Let's say that of the 90%, 20% of straight people This study provides an examination of HIV risks among GLB and heterosexual youth. <br/><br/>The perception that heterosexual men do not contract HIV has lead to them often being diagnosed later, resulting in more advanced condition and also greater risk to any partners they may have. Patients with subtype C infection were more frequently female, heterosexual and had Sep 6, 2023 · Compare that to the heterosexual percentage of 90%, which we don't cut in half, because there is always the male component in heterosexual sex. 39% (14,700) of new HIV infections in US men were in blacks, 35% (13,200 . Less common ways are: An HIV-positive person transmitting HIV to their baby during pregnancy, birth, or breastfeeding. Both AIDS surveillance and HIV seroprevalence follow-up studies indicate that an appreciable proportion of HIV infection among women in the United States is acquired through heterosexual contact. Also, in 2021, 25% of new HIV infections were among Black gay and bisexual men, 22% among Latino gay and bisexual men, and 44% among gay Jun 18, 2020 · Among Black gay and bisexual men, from 2010 to 2017: The rate of HIV diagnoses among 13 to 24 year olds went down by 11%. The HIV epidemic continues to disproportionately impact gay and bisexual men, transgender women, youth 13-24 and communities of color. Undiagnosed HIV infection, as well as a lack of retention in care among those diagnosed, are both primary factors contributing to ongoing HIV incidence. This scale assesses the level of HIV-specific social support from one’s partner or specifically support received and given around HIV risk and/or coping with being HIV-positive. , and over a quarter of HIV infected individuals are heterosexuals. HIV is a concern for heterosexual men, as almost 14% of new male HIV cases in 2016 occurred among heterosexuals, through sex with a woman (9. gov Jul 18, 2018 · Men with same-sex sexual partners are 28 times more likely to contract HIV than their heterosexual counterparts despite a radical reduction in new infections among gay men in Western countries, a HIV has been transmitted in 80% of cases as a result of heterosexual activity; perinatal and blood transfusions each account for about 10% of cases. 48) and among men the range was 24% Of all new HIV diagnoses in the United States, 67% were among gay, bisexual, and other men who reported male-to-male sexual contact. Get the latest data on HIV among transgender people. Despite some global progress around health equity, being gay or transgender is still Mar 3, 1992 · MAIN OUTCOME MEASURES--HIV infection in partners and high risk sexual behaviour. , 2012). This means that in the UK as a whole, 52% of people living with HIV are heterosexual. HIV-1 is the virus that was initially discovered and termed both lymphadenopathy associated virus (LAV) and human T-lymphotropic virus 3 (HTLV-III). Nov 30, 2019 · The Health Department said there was still much to learn about the rising prevalence of HIV in middle-aged heterosexual men, but it was believed a lack of awareness and understanding of the virus Jul 3, 2023 · They are also unfairly perceived by society as a group among which sexual transmitted diseases (e. Apr 11, 2010 · Since there tends to be greater overlap between women’s sexual and drug using networks compared to men’s , and because male-to-female HIV transmission is more efficient than female-to-male transmission, heterosexual females may be more likely to acquire HIV from their IDU sex partners than males. With more than thirty years of the HIV epidemic, there is still no cure or an effective vaccine, however, there have been major advances in treating HIV [1-3] as the availability and rapid scale up of antiretroviral therapy (ART) has transformed what was inevitably a fatal disease to a chronic, manageable condition leading to notable declines in the worldwide rates of AIDS Jan 13, 2023 · HIV ( human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high risk for HIV. Introduction. Most of those cases were among Black (63%) and Latino (22%) men, and men living in the Southeast (62%) and Northeast (19%) of the US While HIV affects all races and ethnicities in the United States, some groups are disproportionately affected compared to their population size. Beginning in April 2005, the study enrolled 1,763 heterosexual couples ages 18 or older in Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe. For example, in New York City, only 31% of high-risk heterosexual men and 35% of women had recently tested despite nearly all (>90%) encountering settings where HIV testing was offered [ 9 ]. The number of sexual partners was not associated with any HIV-related social cognitive mediator, suggesting that alternative theoretical Oct 10, 2021 · Men who have sex with men (MSM) are potentially at high risk for HIV infection, their HIV prevalence far exceeds the national prevalence rate. Mutations 63P and 36I, previously reported as common in HIV-1 subtypes B and C from Brazil, respectively, were common. Seronegative partners were randomly assigned to once-daily tenofovir (TDF), combination emtricitabine/tenofovir (FTC/TDF), or matching Dec 18, 2023 · According to CDC, they accounted for 70% of the 32,100 estimated new infections in 2021, even though they made up only 2% of the population, with the highest burden among Black and Latino gay and bisexual men. 9% reported having two or more sexual partners, 6. Conclusion: There is a significant frequency of HIV-1 non-B infections in Paraná state, with isolates classified as subtypes C, F, BF and BC. For each condomless act with an untreated HIV-positive partner, the risk of infection has been estimated at 1. Apr 22, 2024 · HIV infections among people who reported heterosexual contact. HIV testing is less common among heterosexuals than other risk groups such as men who have sex with men and persons who inject drugs . Heterosexual people were also more likely to get diagnosed later in life, meaning their immune systems had already suffered more damage. Learn more. However, it may be 10 to 25 times higher if the positive partner is Mar 10, 2022 · HET is a more common abbreviation of heterosexual (transmission) than HSX. 9%). Dec 13, 2013 · Thirty years since the discovery of HIV, the HIV pandemic in sub-Saharan Africa accounts for more than two thirds of the world’s HIV infections. An increase in recombinant viruses suggests that coinfection and superinfection by divergent HIV strains has become more common necessitating continuous surveillance … Nov 9, 2021 · Takeaway. Yet this subpopulation of “individuals residing in HRA” (IR-HRA) evidence low rates of regular HIV testing Mar 9, 2020 · As seen in Figure 1, women are most likely to contract HIV through heterosexual sex (85% in 2018), followed by injection drug use (15%). Despite the fact that the authors show in Table S6 that, with the exception of China, healthy women generally exhibit higher CD4 T cell counts than men, this is not fully developed in the paper. Jan 6, 2023 · In the United States, most women get HIV from having sex with a man. The network analysis revealed that among PLHIV, heterosexual contact was associated with the highest risk of AHD, followed by injection drug use (odds ratio [OR]=0•56, 95% credible interval [CrI] 0•47–0•68), and men who have sex with men (OR=0•54, 95% CrI 0•46–0 Aug 31, 2016 · Across the United Kingdom, there are approximately 45,000 men living with HIV who were infected through sex with other men (MSM). The “down low” is a situation in which male partners concurrently have sex with Apr 24, 2024 · Gay, bisexual, and other men who reported male-to-male sexual contact are disproportionately affected by HIV. 473 vs. ” Of the 2,023 people diagnosed with HIV in England in 2021, 36% were gay, bisexual or other men who have sex with men. These challenges include feeling additional HIV stigma (Brener et al. We conducted a randomized, three-arm trial of oral antiretroviral PrEP among heterosexual couples from Kenya and Uganda in which one member was HIV-1 seronegative and the other HIV-1 seropositive. Feb 24, 2022 · The total number of people who received a diagnosis for HIV in England in the same year was 2,630. In other words, the chances of coming in contact with the virus and thus also the risk of Lack of focus on heterosexual Black men is likely attributable to the ongoing assumption that Black men acquire HIV via same sex behavior, and heterosexual HIV risk for Black women is because of the “down low” among Black men (Aral, Adimora, & Fenton, 2008). The first case of a syndrome now so-called AIDS was presented in 1981 among healthy American men who have sex with men (MSM; CDC, 1981a,b,c). Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month after diagnosis of HIV infection. London continues to have the highest rates of HIV in England: 32% of new diagnoses in 2021 were in London residents. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage of the disease. The latest news and research on sexual transmission. 1% compared to 8. Health Security Agency (HSA), 50% of new HIV diagnoses in 2021 were in heterosexual individuals, compared to 45% in gay and bisexual men. However, heterosexual youths demonstrated the highest level of condom skills. Among adults in the United States, the most common route of transmission for hepatitis B virus is sexual contact Among the 26% of persons with case-reports of acute HBV infection with information about risk behaviors or exposures, 22. cc qp lw da yn dz rp sq kk dr