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"Female to male transmission in the US is pretty rare."

Dec 12, 2012

Dr Wohl,

I noticed in a recent answer to a question you've stated, "Female to male transmission in the US is pretty rare." This makes me wonder;

Where do the heterosexual males who infect females get the virus from to begin with?

Thank you for all your hard work!

Response from Dr. Wohl

This is a great question and one many people are thinking about. It is clear just from asking folks testing positive what their risk factors for HIV are that the vast majority of men with HIV acquired the virus from a man. But, not all did. Some, of course, were infected through injection drug use. What about the others?

Some have made a case for under-reporting of sex with men by men and closeted sex (i.e., down low). Certainly in a society that has a fair share of homophobia, this is true. However, there is good reason to believe that there is some transmission from women to men also going on. It is really hard to quantify. Thus, I think it does occur but is not common. Should men wear condoms when having sex with women of unknown or positive HIV status? Absolutely.


have sex with bi sexual man whom he is married, there both negative
Please answer Dr. Shannon / Dr. Richard

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