Archives of Sexual Behavior

, Volume 24, Issue 4, pp 383–393 | Cite as

Lack of evidence for transmission of human immunodeficiency virus through vaginal intercourse

  • Stuart Brody


Research in determining risks for human immunodeficiency virus (HIV) transmission is confounded by many issues. They include lack of clarity or specificity in terminology used, respondents misunderstanding of questions, and lying. The base rate of lying (or social desirability responding) by itself is sufficient to account for the small percentage of Americans and Europeans claiming “heterosexual” transmission from partners not known to be intravenous drug users. This study integrates the physiological and epidemiological data on risk factors for HIV transmission with the psychological literature on the frequency of anal intercourse and of lying (in this case to researchers and clinicians about risk factors). When these factors are considered, intravenous and anal activities remain the only clear vectors for HIV transmission. Research suggesting that spermicidals are more effective at inactivating HIV than condoms are at physically containing HIV is also noted.

Key words

AIDS HIV anal intercourse social desirability 


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  1. Albert, A. E., Hatcher, R. A., and Graves W. (1991). Condom use and breakage among women in a municipal hospital family planning clinic.Contraception 43: 167–176.PubMedGoogle Scholar
  2. American Psychiatric Association. (1987).Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev., APA, Washington, DC.Google Scholar
  3. Beral, V., Bull, D., Darby, S., Weller, I., Carne, C., Beecham, M., and Jaffe, H. (1992). Risk of Kaposi's sarcoma and sexual practices associated with faecal contact in homosexual or bisexual men with AIDS.Lancet 339: 632–635.PubMedGoogle Scholar
  4. Carey, R. F., Herman, W. A., Retta, S. M., Rinaldi, J. E., Herman, B. A., and Athey, T. W. (1992). Effectiveness of latex condoms as a barrier to human immunodeficiency virus-sized particles under conditions of simulated use.Sex. Transmit. Dis. 19: 230–234.Google Scholar
  5. Centers for Disease Control. (1993).October 1993 HIV/AIDS surveillance report, 3rd-Quarter ed., U.S. Government Printing Office, Washington, DC.Google Scholar
  6. Chave, J. P., Juvet, A., Maziero, A., and Francioli, P. (1990). 364 tests anonymes de depistage du SIDA au Centre Hospitalier Universitaire Vaudois: qui, pourquoi? [364 anonymous screening tests for AIDS at the Vaudois University Hospital Center: who? why?].Schweiz. Med. Wochenschr. 120: 335–338.PubMedGoogle Scholar
  7. Coates, R. A. Calzavara, L. M., Soskolne, C. L., Read, S. E., Fanning, M. M., Shepherd, F. A., Klein, M. H., and Johnson, J. K. (1988). Validity of sexual histories in a prospective study of male sexual contacts of men with AIDS or an AIDS-related condition.Am. J. Epidemiol. 128: 719–728.PubMedGoogle Scholar
  8. Corby, N. H., Wolitski, R. J., Thornton-Johnson, S., and Tanner, W. M. (1991). AIDS knowledge, perception of risk, and behaviors among female sex partners of injection drug users.AIDS Educ. Prevent. 3: 353–366.Google Scholar
  9. Crowne, D. P., and Marlowe, D. (1964).The Approval Motive, Wiley, New York.Google Scholar
  10. Curran, J. W., Jaffe, H. W., Hardy, A. M., Morgan, W. M., Selik, R. M., and Dondero, T. J. (1988). Epidemiology of HIV infection and AIDS in the United States.Science 239: 610–616.PubMedGoogle Scholar
  11. Darrow, W. W., Jaffe, H. W., Thomas, P. A., Haverkos, H. W., Rogers, M. F., Guinan, M. E., Auerbach, D. M., Spira, T. J., and Curran, J. W. (1986). Sex of interviewer, place of interview, and responses of homosexual men to sensitive questions.Arch. Sex. Behav. 15: 79–88PubMedGoogle Scholar
  12. de Lima e Costa, M. F., Oliveira, M. R., Oliveira, E. I., Paulino, U. H., Greco, D. B., Chiari, C. A., Guimaraes, M. D., Proietti, F. A., Antunes, C. M., and Munoz, A. (1990). Factors associated with AIDS and AIDS-like syndrome among homosexual and bisexual men in Minas Gerais, Brazil.Int. J. Epidemiol. 19: 429–434.PubMedGoogle Scholar
  13. Eysenck, H. J., and Eysenck, S. B. G. (1975).Manual for the Eysenck Personality Questionnaire, EdITS, San Diego, CA.Google Scholar
  14. Fultz, P. N., McClure, H. M., Daugharty, H., Brodie, A., McGrath, C. R., Swenson, B., and Francis, D. P. (1986). Vaginal transmission of human immunodeficiency virus (HIV) to a chimpanzee.J. Infect. Dis. 154: 896–900.PubMedGoogle Scholar
  15. Fumento, M. A. (1987). AIDS: Are heterosexuals at risk?Commentary 84: 21–27.Google Scholar
  16. Hathaway, S. R., and McKinley, J. C. (1948).Minnesota Multiphasic Personality Inventory, Psychological Corp., New York.Google Scholar
  17. Henry, K. (1991). Documented male-to-female transmission of HIV-1 after minimal vaginal exposure in the absence of other cofactors for infection.Minnesota Med. 74: 32–34.PubMedGoogle Scholar
  18. Hicks, D. R., Martin, L. S., Getchell, J. P., Heath, J. L., Francis, D. P., McDougall, J. S., Curran, J. W., and Voeller, B. (1985). Inactivation of HTLV-III/LAV-infected cultures of normal human lymphocytes by nonoxynol-9 in vitro.Lancet 2: 1422–1423.PubMedGoogle Scholar
  19. Jones, B. M., and Willcox, L. M. (1991). The susceptibility of organisms associated with bacterial vaginosis to spermicidal compounds in vitro.Genitourinary Med. 67: 475–477.Google Scholar
  20. Keet, I. P., Albrecht van Lent, N., Sandfort, T. G., Coutinho, R. A., and van Griensven, G. J. (1992). Orogenital sex and the transmission of HIV among homosexual men.AIDS 6: 223–226.PubMedGoogle Scholar
  21. Klebanoff, S. J., and Coombs, R. W. (1991). Viricidal effect of Lactobacillus acidophilus on human immunodeficiency virus type 1: Possible role in heterosexual transmission.J. Exp. Med. 174: 289–292.PubMedGoogle Scholar
  22. Lippard, P. V. (1988). “Ask me no questions, I'll tell you no lies”: Situational exigencies for interpersonal deception.Western J. Speech Commun. 52: 91–103.Google Scholar
  23. MacDonald, N. E., Wells, G. A., Fisher, W. A., Warren, W. K., King, M. A., Doherty, J. A., and Bowie, W. R. (1990). High-risk STD/HIV behavior among college students.J. Am. Med. Assoc. 263: 3155–3159.Google Scholar
  24. Melbye, M., and Biggar, R. J. (1992). Interactions between persons at risk for AIDS and the general population in Denmark.Am. J. Epidemiol. 135: 593–602.PubMedGoogle Scholar
  25. Miller, C. J., Alexander, N. J., Sutjipo, S., Lackner, A. A., Gettie, A., Hendrickx, A. G., Lowenstine, L. J., Jennings, M., and Marx, P. A. (1989). Genital mucosal transmission of simian immunodeficiency virus: Animal model for heterosexual transmission of human immunodeficiency virus.J. Virol. 63: 4277–4284.PubMedGoogle Scholar
  26. Newcomer, S., and Udry, J. R. (1988). Adolescents' honesty in a survey of sexual behavior.J. Adolescent Res. 3: 419–423.Google Scholar
  27. Padian, N., Marquis, L., Francis, D. P., Anderson, R. E., Rutherford, G. W., O'Malley, P. M., and Winkelstein, W. (1987). Male-to-female transmission of human immunodeficiency virus.J. Am. Med. Assoc. 258: 788–790.Google Scholar
  28. Padian, N., Shiboski, S. C., and Jewell, N. P. (1991). Female-to-male transmission of human immunodeficiency virus.J. Am. Med. Assoc. 266: 1664–1667.Google Scholar
  29. Peterman, T. A., Stoneburner, R. L., Allen, J. R., Jaffe, H. W., and Curran, J. W. (1988). Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections.J. Am. Med. Assoc. 259: 55–58.Google Scholar
  30. Polsky, B., Segal, S. J., Baron, P. A., Gold, J. W., Ueno, H., and Armstrong D. (1989). Inactivation of human immunodeficiency virus in vitro by gossypol.Contraception 39: 579–587.PubMedGoogle Scholar
  31. Potterat, J. J., Phillips, L., and Muth, J. B. (1987). Lying to military physicians about risk factors for HIV infections.J. Am. Med. Assoc. 257: 1727.Google Scholar
  32. Psychoyos, A., Creatsas, G., Hassan, E., Georgoulias, V., and Gravanis, A. (1993). Spermicidal and antiviral properties of cholic acid: Contraceptive efficacy of a new vaginal sponge (Protectaid) containing sodium cholate.Hum. Reprod. 8: 866–869.PubMedGoogle Scholar
  33. Roddy, R. E., Cordero, M., Cordero, C., & Fortney, J. A. (1993). A dosing study of nonoxynol-9 and genital irritation.Int. J. STD AIDS 4: 165–170.PubMedGoogle Scholar
  34. Rosenblum, L., Darrow, W., Witte, J., Cohen, J., French, J., Gill, P. S., Potterat, J., Sikes, K., Reich, R., and Hadler, S. (1992). Sexual practices in the transmission of hepatitis B virus and prevalence of hepatitis delta virus infection in female prostitutes in the United States.J. Am. Med. Assoc. 267: 2477–2481.Google Scholar
  35. Russell-Brown, P., Piedrahita, C., Foldesy, R., Steiner, M., and Townsend, J. (1992). Comparison of condom breakage during human use with performance in laboratory testing.Contraception 45: 429–437.PubMedGoogle Scholar
  36. Saxe, L. (1991). Lying: Thoughts of an applied social psychologist.Am. Psychol. 46: 409–415.Google Scholar
  37. Voeller, B. (1991). AIDS and heterosexual anal intercourse.Arch. Sex. Behav. 20: 233–236.PubMedGoogle Scholar
  38. Voeller, B., and Anderson, D. J. (1992). (Letter),J. Am. Med. Assoc. 267: 1917–1918.Google Scholar
  39. Wainberg, M. A., Spira, B., Bleau, G., and Thomas, R. (1990). Inactivation of human immunodeficiency virus type 1 in tissue culture fluid and in genital secretions by the spermicide benzalkonium chloride.J. Clin. Microbiol. 28: 156–158.PubMedGoogle Scholar
  40. Winkelstein, W., Lyman, D. M., Padian, N., Grant, R., Samuel, M., Wiley, J. A., Anderson, R. E., Lang, W., Riggs, J., and Levy, J. A. (1987). Sexual practices and risk of infection by the human immunodeficiency virus.J. Am. Med. Assoc. 257: 321–325.Google Scholar

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Stuart Brody
    • 1
  1. 1.Department of Medical PsychologyEberhard-Karls-University TübingenTübingenGermany

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