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Intercourse During Menstruation Among Prostitutes

Stephen T. Green, MD, BSc, MRCP; David J. Goldberg, BSc, MRCP; Dilip Nathwani, MRCP; Peter R. Christie, PhD, MB ChB; Ann Thomson, RGN, HV
JAMA. 1990;264(3):333. doi:10.1001/jama.1990.03450030049013.
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To the Editor.—  Dr Brown's recent letter1 pointed out that if vaginal intercourse were to take place during the menstrual period, such an act might be more likely to bring men into direct contact with blood potentially infected with the human immunodeficiency virus (HIV) and hence increase the risk of female-to-male HIV transmission. It is known that in most women it is only during active menstruation that cells capable of hosting HIV are secreted from the cervix,2 suggesting that vaginal intercourse during this period would indeed be more hazardous than at other times; the question is whether vaginal intercourse ever takes place during menstruation, and, if so, when.The recent World Health Organization Consultation on HIV Epidemiology and Prostitution3 underlined the potential for prostitute-client interaction as a possible route of sexual transmission of HIV from clients to prostitutes and vice versa. During a recent Glasgow study of


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