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Prevalence and Correlates of Heterosexual Anal Intercourse among Men and Women, 20 U.S. Cities

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Factors thought to influence this sexual transmission include 1 promiscuity, with a high prevalence of sexually transmitted disease; 2 sexual practices that have been associated with increased risk of transmission of AIDS virus homosexuality and anal intercourse ; and 3 cultural practices that are possibly connected with increased virus transmission female "circumcision" and infibulation. Other nonsexual cultural practices that do not fit the age distribution pattern of AIDS but may expose individuals to HIV include 1 practices resulting in exposure to blood medicinal bloodletting, rituals establishing "blood brotherhood," and possibly ritual and medicinal enemas ; 2 practices involving the use of shared instruments injection of medicines, ritual scarification, group circumcision, genital tatooing, and shaving of body hair ; and 3 contact with nonhuman primates. At the current time promiscuity seems to be the most important cultural factor contributing to the transmission of HIV in Africa. The recent spread of AIDS throughout Africa raises the question of whether the mode of transmission of human immunodeficiency virus HIV in Africa is different from that in the United States and other Western countries. This report briefly examines cultural practices that may contribute to the spread of AIDS in Africa and highlights areas that require further research.

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