Female-to-Male Transmission of AIDS

To the Editor.— Drs Haverkos and Edelman 1 have addressed perhaps the most important unanswered epidemiologic question regarding human T-cell lymphotropic virus type III (HTLV-III) / lymphadenopathy - associated virus (LAV) transmission. The answer to it will determine the ultimate magnitude of the current pandemic of the acquired immunodeficiency syndrome (AIDS). Fortunately for human society, these authors are probably incorrect in suggesting frequent female-to-male transmission of HTLV-III/LAV. No data are currently available to support the contention that this virus is spread sexually from women to men, at least with other than low frequency/efficiency. Reducing sexual promiscuity—heterosexual and homosexual—may be a sensible public health goal, but this should be achieved with appropriate interventions based on valid data. With the exception of pregnancy, we are accustomed to thinking of sexually transmitted conditions as bidirectional. It has been amply documented that infected men can and do transmit HTLV-III/LAV to susceptible women through various sexual practices,