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To the Editor.— In their valuable report on acquired immunodeficiency syndrome (AIDS) in women, Guinan and Hardy1infer that heterosexual anal intercourse plays little part in the sexual spread of the AIDS virus (the human immunodeficiency virus HIV), a viewpoint editorially echoed in the same issue ofJAMA.2However, inasmuch asreceptiveanal intercourse carries the highest relative risk by far for homosexual men, we underestimate the practice among heterosexuals at some peril. Sex researchers, unlike most physicians, are familiar with data indicating that about one fourth of American women occasionally engage in anal intercourse and about 10% do so regularly for pleasure.3,4We find that such information is obtained from most women only after repeated personal interviews and development of strong trust in the interviewer.5Thus, standard medical or field interviews are unlikely to reveal such activity, reinforcing the mistaken impression that anal intercourse is
Bruce Voeller (Fri,) studied this question.
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