Promoting safer sex in the context of heterosexual anal intercourse: A scoping review

Abstract

Aims and objectives To locate and summarise existing literature regarding safer sex practices specific to heterosexual anal intercourse and identify promising health promotion strategies. Background Much of the literature regarding anal intercourse and safer sex is related to men who have sex with men. However, some studies suggest there are more women than men engaging in unprotected receptive anal intercourse. The risks associated with this sexual practice have been well documented, although many healthcare providers fail to ask about anal intercourse while addressing safer sex in the heterosexual population. Design The study was based on Arksey and O’Malley's 2005 five‐step methodology. Methods A search was conducted of MEDLINE; CINAHL; PsycInfo; Cochrane; and PubMed. Databases were searched from 1990–2020. The 72 studies selected were classified according to their main area of focus. A grey literature search was also included. This scientific submission has been assessed for accuracy and completeness using the PRISMA‐ScR guideline criteria (File S1). Results The literature in this area is heterogeneous in terms of method and topic. Prevalence and incidence (n = 26) in addition to sexually transmitted infection risks (n = 26) related to heterosexual anal intercourse are well understood. However, there is limited information on condom use (n = 6), factors that influence heterosexual anal intercourse (n = 10) and health promotion strategies for this population and practice (n = 4). Two websites that mentioned heterosexual anal intercourse risk reduction activities were included. Conclusions Although heterosexual anal intercourse appears to be an increasingly common sexual practice, very little is known about health promotion strategies nurses might use for encouraging safer sex in this population. Relevance to clinical practice Increased awareness of the prevalence and risks of heterosexual anal intercourse could enhance nurses’ harm reduction strategies. Screening for sexually transmitted infections may be based on incorrect assumptions about sexual practices or due to stigma linked with anal intercourse. Reducing unprotected heterosexual anal intercourse will reduce sexually transmitted infections and their long‐term sequelae.

Changes in Sexual Behaviors with Opposite-Sex Partners and Sexually Transmitted Infection Outcomes Among Females and Males Ages 15–44 Years in the USA: National Survey of Family Growth, 2008–2019

“…First, all outcomes were self-reported—many in face-to-face interactions—and therefore sensitive to recall and social desirability bias. Second, in the absence of a question about gender identity in NSFG, our analyses were limited to respondents’ biological sex, and our analyses focused on vaginal sex, despite the potential contributions of oral and anal sex to STI transmission (Ballini et al, 2012 ; Khosropour et al, 2021 ; Stewart et al, 2021 ). Third, we were unable to report outcomes and trends specific to Asian, Native Hawaiian/Pacific Islander, Native American/Alaska Native, or multiracial respondents due to smaller sample sizes for these groups.…”

The Penis, the Vagina and HIV Risk: Key Differences (Aside from the Obvious)

“…However, while a meta-analysis of multiple studies demonstrated that the per-exposure probability of male-to-female HIV transmission was approximately double that of female-to-male [10], additional factors need to be considered. Anal sex is common within heterosexual communities but is under-reported due to stigma [11]; since the anorectal mucosa is much more susceptible to HIV than that of the vagina or penis [12], this could increase per-act HIV risk for the female partner. Patterns of sexual partnering in many areas of SSA mean that HIV-uninfected young women may be more likely to have an older male sexual partner [13], increasing the risk that he is HIV infected.…”

Gestión humana y desempeño de los enfermeros para la atención de pacientes con VIH/SIDA

“…Respecto a labores que desempeña el personal de enfermería para la atención de pacientes con VIH/SIDA en la clínica estuvieron inmersas el monitoreo de signos vitales (Ishmaru et al, 2018;Ajisegiri et al, 2019;Tessorolo et al, 2019;Nijhawan et al, 2020), la ejecución y asistencia de procedimientos (Rabkin et al, 2017;Ishmaru et al, 2018;Ajisegiri et al, 2019;Tessorolo et al, 2019;Nijhawan et al, 2020), administración de medicamentos (McNairy et al, 2017;Ajisegiri et al, 2019;Tessorolo et al, 2019;Nijhawan et al, 2020) y planificación de consultas (Castillo et al, 2021). Por otra parte, en la clínica especializada se pudo apreciar la ayuda al paciente con VIH/SIDA en su proceso de tratamiento o recuperación (McNairy et al, 2017;Rabkin et al, 2017;Ishmaru et al;Achar et al, 2019;Ajisegiri et al, 2019;Tessorolo et al, 2019, Nijhawan et al, 2020, seguimiento de la evolución o involución (Ishmaru et al;Achar et al, 2019;Ajisegiri et al, 2019;Tessorolo et al, 2019;Nijhawan et al, 2020), la preservación de la seguridad (Parmley et al, 2019;Salomon et al, 2019;Stewart et al, 2021), monitoreo de los acontecimientos (Ishmaru et al,2018;Ajisegiri et al, 2019;Tessorolo et al, 2019;Nijhawan et al, 2020), promoción de la salud sexual y reproductiva (Parmley et al, 2019;Salomon et al, 2019;Stewart et al, 2021) (Tabla 3).…”

“…Los pacientes con tratamiento antirretrovirales disminuyen significativamente la carga viral, sin embargo, hay otras opciones como el uso de preservativo. En su tiempo de mayor contacto con el paciente puede instruir a tal modo de llegar a repercutir significativamente sobre su calidad de vida (Parmley et al, 2019;Salomon et al, 2019;Stewart et al, 2021).…”