Background: Key strategies advocated for lowering personal risk of sexual exposure to STD/HIV include having fewer partners and avoiding risky partners. However, few studies have systematically examined how well people can actually discern their sex partners' risk behaviours. Methods: We conducted face to face interviews with 151 heterosexual patients with gonorrhoea or chlamydial infection and 189 of their sex partners. Interviews examined the patients' perceptions of their sex partners' sociodemographic characteristics and risk behaviours. Patients' perceptions of partners were then sociometrically compared for agreement with partner self reports, using the kappa statistic for discrete variables and concordance correlation for continuous variables. Results: Agreement was highest for perceived partner age, race/ethnicity, and duration of sexual partnership; and lowest for knowledge of partner's work in commercial sex, number of other sex partners, and for perceived quality of communication within the partnership. Index patients commonly underestimated or overestimated partners' risk characteristics. Reported condom use was infrequent and inconsistent within partnerships. Conclusion: Among people with gonorrhoea or chlamydial infection, patients' perceptions of partners' risk behaviours often disagreed with the partners' self reports. Formative research should guide development and evaluation of interventions to enhance sexual health communication within partnerships and within social networks, as a potential harm reduction strategy to foster healthier partnerships.

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Of 88,510 cases of acquired immunodeficiency syndrome (AIDS) reported in adults in the United States from 1983 through 1988, the percentage attributed to reported heterosexual contact with persons known to be infected or at increased risk of infection with human immunodeficiency virus (HIV) has increased steadily from 0.9 percent in the first quarter of 1983 to 4.0 percent in the fourth quarter of 1988, from 0.1 (in 1983) to 1.4 percent (in 1988) among men, and from 13 (in 1983) to 28 percent (in 1988) among women. Among women, the cumulative incidence of AIDS attributable to heterosexual contact per million population is over 11 times greater for Blacks and Hispanics than for Whites. Among men, this IntroductionEarly during the AIDS (acquired immunodeficiency syndrome) epidemic, there was considerable concern that AIDS would spread rapidly among heterosexuals in North America and Europe. These concerns were heightened by emerging evidence of heterosexual acquisition of AIDS in Africa. When the heterosexual AIDS epidemic did not rapidly materialize in industrialized countries, these concerns came to be regarded with skepticism. This paper provides an analysis of trends in the frequency and percentage of cases of AIDS in the United States thought to have been acquired heterosexually, together with a perspective on heterosexual transmission of HIV (human immunodeficiency virus) in the context of a general overview of heterosexually transmitted infections.