What is “Heterosexual Contact” Anyway?

Is it possible that we are gathering incomplete statistics about HIV risk factors because the wrong questions are being asked? Two microbicide advocates, Marc-Andre Leblanc and Dr. Kate Morrow examine this question as their research on women and anal sex challenges presumptions behind the “heterosexual contact” risk category.

Citing research from the US, Leblanc writes, “In absolute numbers, 7 times more heterosexual women than gay men in the US practice receptive anal intercourse.” (Less Silence More Science: Advocacy to Make Rectal Microbicides a Reality, p.12). Seven times. And yet, when statistics are reported about risk factors for HIV infection, the heterosexual contact category does not specify vaginal or anal sex. (The BC Centre for Disease Control (BC CDC), Public Health Agency of Canada, and US Centre for Disease Control all use the term "heterosexual contact" in epidemiology reports).

In a teleconference presentation for the International Rectal Microbicide Advocates, Morrow shared findings from a study on women who practiced anal sex. She found that even when women used condoms for vaginal sex, 82% didn’t use them for anal sex. That’s a lot of risk for HIV infection. And it adds urgency for the development of microbicides.  Discussion on the topic since this presentation has included  the point that women might have anal sex in one relationship but not another, and we need to know more about what people are doing so we can provide the appropriate support and education. 

We are still a few years from a vaginal microbicide, and even longer for a rectal microbicide. Money is desperately needed for research on both. To underline that need, statistics must report not on “heterosexual contact” (the people involved) but what they are doing that poses risk. Any assumptions about so-called normal sex (vaginal intercourse) and so-called abnormal sex (anal intercourse) need to be abandoned. We need data on heterosexual contact that includes vaginal and anal sex, both to normalize it and gather accurate information. We better get talking.

- Janet

This was posted on Friday, August 15th, 2008 at 10:00 am and is filed under Education & Resources, HIV Prevention . Feel free to respond, or trackback. Read our comments policy.

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