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Nancy S. Padian, PhD; Stephen C. Shiboski, PhD
University of California, San Francisco

Nicholas P. Jewell, PhD
University of California, Berkeley

JAMA. 1992;267(14):1918-1919.

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In Reply.

—We did not attempt to examine gender-specific transmission rates by anal intercourse because we did not believe it to be a risk factor for female-to-male transmission. Anal intercourse among the uninfected male partners of infected women seems analogous to insertive anal intercourse between uninfected male partners of infected men, which poses far less risk than receptive anal intercourse.¹ There is no evidence that anal intercourse is prevalent in pattern II countries where bidirectional heterosexual transmission is common (areas of central, eastern, and southern Africa and in some Caribbean countries). Nevertheless, Dr Godfrey poses an interesting hypothesis: male-to-female transmission in our study could largely be attributed to anal intercourse, and once this practice is controlled for, rates of female-to-male transmission might approximate rates of male-to-female transmission.

Overall, we observed that 20% of 307 female partners of infected males were infected. One hundred ninety-three (37%) of these couples practiced . . . [Full Text PDF of this Article]

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