The "Ruth" that we meet in Shore Leave is not a real woman. She is, as Spock would say, "a mechanical contrivance". In short, she's an android, and not a sentient one like TNG's Data, either.
She represents a woman that Captain Kirk knew 15 years earlier, during his academy days. The exact nature of Kirk's relationship with the real Ruth is never described, or explained. Judging by the lukewarm welcome they give to each other, it's not really safe to assume that Kirk was in love with Ruth. Judging only from what we see in the episode, it's impossible to tell if she's a ex-lover, a woman he admired from afar, his sister or cousin, or what.
At the end, Kirk sees her at a distance, decides to stay on the surface for a couple of days, and ambles off toward her, knowing full well at that point that she is just an android. Many people assume from that that he then has sex with her, but he might just be going to have a fight with her, like he did with the Android "Finnegan". For all we know, Ruth is a woman that Kirk's been burning to tell off for a long, long time. There really is no solid reason to think that Kirk ever did or ever would make love to her.
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