Unprotected sexual intercourse with HIV-infected men is the major cause of new infections. HIV virions are released into semen by various cells of the male genital tract, as well as by infected monocytes and lymphocytes present in semen. Some of these virions may attach to the surfaces of cells, infected or uninfected. We investigated whether cells carrying attached HIV on their surfaces can transmit infection. We addressed this question in a model system of human tissue exposed ex vivo to monocytes and lymphocytes carrying HIV on their surfaces. We gamma irradiated the cells to prevent their productive infection. In spite of comparable amounts of HIV attached to monocytes and lymphocytes, only monocytes were capable of transmitting infection and triggering productive infection in tissue. This HIV-1 transmission was mediated by cell-cell contacts. Our experiments suggest that in vivo, HIV attached to infected or uninfected monocytes, which far outnumber lymphocytes in HIV-infected semen, may contribute to sexual transmission of HIV from men to their partners. T ransmission of human immunodeficiency virus (HIV) occurs mainly through unprotected sexual intercourse, in which seminal HIV is deposited on rectal or vaginal mucosa (1-3). The probability of HIV transmission positively correlates with the viral load in semen and varies from 1/200 to 1/2,000 for male-to-female transmission and from 1/10 to 1/1,600 for male-to-male transmission (4). In semen, HIV exists in different forms: (i) free-floating viral particles, (ii) viruses in infected cells (in particular monocytes and lymphocytes [5-8]), and (iii) viral particles that after being released by infected cells reattached to the surfaces of cells, infected or uninfected.Earlier, it was shown that both cell-free HIV and infected cells are capable of transmitting infection in ex vivo models and in nonhuman primates (9, 10), although the relative contributions of these two pools to HIV transmission remain a matter of debate (reviewed in references 6 and 11). In particular, whether virus attached to the surfaces of seminal cells of HIV-infected individuals can transfer HIV infection is not clear. Since many of the seminal cells express various HIV receptors or express a wide variety of surface molecules involved in HIV attachment (2, 12, 13), there are reasons to consider these cells vehicles for HIV sexual transmission from an infected male to his uninfected partner, as has been suggested with regard to spermatozoa (14).Here, we address this question by comparing tissue infections ex vivo with cell-free HIV and with cell-attached HIV. In particular, we investigated whether HIV adsorbed at the surfaces of lymphocytes or monocytes, two major types of cells present in the semen of infected individuals, can transmit infection to human tissue ex vivo. We found that in this model, only HIV attached to monocytes, but not that attached to lymphocytes, was able to transmit infection, and the transmitted virus replicated in the recipient tissue similarly to cell-free ...