Dying of embarrassment: The HIV/AIDS risk factor that dare not speak its name
There is one behavior that the health community has studiously avoided discussing, and it’s essential that we do. Receptive anal intercourse (AI), which is a recognized HIV risk behavior for men who have sex with men, has been ignored as a risk factor for women who engage in AI with men. Yet, more heterosexual couples engage in AI than male couples. This is a grave disservice to women, because they do not recognize the risks associated with AI.
In fact, my colleagues and I have data suggesting that teenagers may actually view AI as safer than vaginal intercourse. After all, nobody is telling them not to do it, and it does not lead to pregnancy.
- My recent NIH-funded study of Black and Latina adolescent and young adult women, and our follow-up study, found that 25% to 35% of study participants had engaged in this behavior. Moreover, very few used condoms; the rate of condom use was lower for AI than it was for vaginal intercourse.
- While we have presented these data at one nursing meeting, our efforts to publish these findings in major public health and medical journals have, as yet, been futile. Furthermore, the CDC and WHO do not even collect data on this behavior. Sexual transmission of HIV in women is listed simply as “heterosexual transmission.” The specific behavior is rarely delineated.
- Yet, basic science research suggests that HIV is much more easily transmitted through contact with anal mucosa than with vaginal mucosa.
Clinicians and public health professionals must educate women about the risks associated with AI. Women may be dying of our embarrassment with this subject.
< Previous | Next >
Return to list of issues