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To investigate the risk factors for man-to-woman sexual transmission of the human immunodeficiency virus HIV , we carried out a cross-sectional study of women who were steady partners of HIV-infected men attending 16 Italian clinical centers. Information was collected from the medical records of the infected men and by direct interviews with the women. In a logistic regression analysis, the woman's awareness of her partner's seropositivity odds ratio [OR], 0. An increased risk was found in women having sexual intercourse more than twice a week OR, 2. The transmission rate was higher in couples who engaged in anal sex OR, 2. Knowledge of the HIV status of the partner led to increased condom use but did not induce a lower frequency of sexual intercourse or an avoidance of anal sex.