Abstract:BackgroundFemale anal sex is a receptive type of sexual practice among heterosexual couples where the penis is inserted into the anus of a female partner. In the Western world, a number of studies and interventions have been carried out on anal sex among men due to its potential risks to HIV transmission. In African countries, including Tanzania, there is dearth of information on the risks inherent in practices associated with female anal sex in the general population. The objective of this study was to determ… Show more
“…Studies have shown that anal intercourse carries one of the highest-risk of sexual activity for getting HIV. Our results suggest that anal intercourse not only increases the risk of HIV acquisition but also from T. pallidum, and the same infection mechanism can be applied to men who have sex with men and heterosexuals [14,23,24].…”
Section: Discussionmentioning
confidence: 73%
“…Having anal sex with high frequency (> 50% of sexual encounters) during the last year was another factor that increased the prevalence of syphilis infection. Anal intercourse increases the risk of STIs because of the characteristic of the rectum, which shows a delicate tissue that can be easily damaged, which is aggravated by the limited lubrification, giving access to bacteria and virus to the bloodstream [22][23][24]. Studies have shown that anal intercourse carries one of the highest-risk of sexual activity for getting HIV.…”
Background: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. Methods: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). Results: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. Conclusions: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.
“…Studies have shown that anal intercourse carries one of the highest-risk of sexual activity for getting HIV. Our results suggest that anal intercourse not only increases the risk of HIV acquisition but also from T. pallidum, and the same infection mechanism can be applied to men who have sex with men and heterosexuals [14,23,24].…”
Section: Discussionmentioning
confidence: 73%
“…Having anal sex with high frequency (> 50% of sexual encounters) during the last year was another factor that increased the prevalence of syphilis infection. Anal intercourse increases the risk of STIs because of the characteristic of the rectum, which shows a delicate tissue that can be easily damaged, which is aggravated by the limited lubrification, giving access to bacteria and virus to the bloodstream [22][23][24]. Studies have shown that anal intercourse carries one of the highest-risk of sexual activity for getting HIV.…”
Background: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. Methods: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). Results: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. Conclusions: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.
“…One Nigerian publication out of the 38 articles reported the prevalence of oral and anal sex as a combined outcome [43]. Six articles were mixed method studies (a study each from Ethiopia, Kenya, Nigeria, Tanzania, Zambia and another was conducted in Kenya and Rwanda) [39, 66, 70, 90, 120, 133]. Fifty-nine studies were from Southern Africa, 38 were from East Africa, 20 were from West Africa and four were from Central Africa (Additional file 2: Table S1).Fig.…”
Background
Oral and anal sexual behaviours are increasingly reported among adolescents and adults reporting heterosexual sex in peer-reviewed journals in high income countries, but less is known about these behaviours in low and middle-income countries, especially in sub-Saharan Africa. The aim of this systematic review is to describe the prevalence of, and motivations for, oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa.
Methods
A systematic review of published articles that reported oral and or anal sex in sub-Saharan Africa was conducted from seven databases up to and including 30th August 2018.
Results
Of 13,592 articles, 103 met the inclusion criteria. The prevalence of reporting ever practising oral sex among adolescents, university students and a combined population of adolescents/adults ranged from 1.7–26.6%, 5.0–46.4% and 3.0–47.2% respectively. Similarly, prevalences of reported ever practising anal sex ranged from 6.4–12.4% among adolescents, 0.3–46.5% among university students and 4.3–37.8% amongst combined population of adolescents and adults. Higher prevalences of oral and anal sex were reported among populations at high-risk for sexually transmitted infections and HIV and university students and, in most studies, both behaviours were more commonly reported by males than females. Heterosexual oral and anal sexual acts were associated with some high-risk behaviours such as inconsistent condom use and multiple sexual partners.
Conclusion
Reported oral and anal sex between men and women are prevalent behaviours in sub-Saharan Africa. Health professionals and policy makers should be aware of these behaviours and their potential associated health risks.
Electronic supplementary material
The online version of this article (10.1186/s12978-019-0722-9) contains supplementary material, which is available to authorized users.
“…With regards to anal sex, the highest prevalence in SSA among people not coming from high-risk groups was found in high-school students in Ethiopia among whom 57% reported anal practices [44], but other studies have found lower prevalences [8,10,16,17,43,47–49]. One out of five sexually active people attending VCT in Kinshasa reported anal intercourse.…”
Section: Discussionmentioning
confidence: 99%
“…The reported prevalence of oral sex comes mainly from young people and ranges from 8% to 52% [43–45], although some particular studies have shown even higher frequencies [46]. Regarding anal sex, figures range from 4% to 57% [8,16,17,43,44,47–50], with most of the information coming from South African studies.…”
BackgroundSexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors.MethodsOKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15–59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data.ResultsAmong 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting “not” having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors.ConclusionsOral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa.
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