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

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.