The purpose of the present study was to investigate heterosexual anal sex and associated factors in two population segments of Cape Town South Africa: The low prevalence of anal intercourse among heterosexuals may be offset by its greater efficiency for transmitting HIV. All comparisons were conducted using logistic regressions. Our primary aim was to describe the occurrence of heterosexual anal intercourse in relation to vaginal intercourse, condom use, and risk-related history factors. Finally, we examined sexual partners and sexual behaviors of men and women who had engaged in heterosexual anal sex in the previous three months.
The community and clinic anonymous surveys were collected between and The two samples differed along several demographic and risk history characteristics. Second, we tested for differences between participants who engaged in heterosexual anal intercourse in the previous three months with those who did not report heterosexual anal sex on all demographic, HIV risk history, substance use and sexual behaviors. Anal intercourse was associated with younger age, being unmarried, having a history of STIs, exchanging sex, using substances, having been tested for HIV, and testing HIV positive. Demographic and HIV risk history characteristics Participants reported their age, race, years of formal education, whether they were employed and their marital status. AI prevalence was high across different recall periods for sexually active general-risk populations e. Sampling procedure Data were collected using time and place sampling procedures in two townships and a major STI clinic in Cape Town. One in five women at high risk for HIV infection in New York City engage in anal intercourse with regular, casual, and commercial sex partners 6. Prevalence was higher in studies using more confidential interview methods. Approximately half of all patients seen at the clinic have previously received STI diagnostic and treatment services. All STI patients were referred to the study. Methods Anonymous surveys collected from convenience samples of men and women in two townships and one large city STI clinic in Cape Town. Questionnaires were administered by teams of field workers recruited from the townships and trained in survey collection, the study protocol, and research ethics, particularly focusing on confidentiality. Participants were approached by a field worker and asked whether they would answer an anonymous questionnaire. Table 1 Demographic characteristics and sexual behaviors of township communities and STI clinic participants. In each township men and women age 18 and older were approached while in public places and asked to complete a brief anonymous survey. Sampling occurred throughout hours of the day and days of the week. Conclusions Anal intercourse is reported relatively less frequently than unprotected vaginal intercourse among heterosexuals. All of the study procedures were approved by the University of Connecticut and Human Sciences Research Council institutional review boards. Categorical variables are shown in the upper panel and continuous variables are shown in the lower panel of the table. The publisher's final edited version of this article is available at Sex Transm Infect See other articles in PMC that cite the published article. The current study examined heterosexual anal intercourse practices among men and women in South Africa. These findings are consistent with other studies that show a significant and potentially growing number of heterosexuals engaging anal sex practices 8 — 9. Among young women, engaging in anal sex was associated with living with a sex partner, having had two or more sex partners, and having experienced coercive sex. The survey included demographic and HIV risk history characteristics, substance use, and sexual behaviors. Although heterosexual anal intercourse carries considerable risk for HIV transmission, the prevalence of anal sex among heterosexuals is not well established.
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