Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa. BMC Public Health 2011 Oct 14;11:807
Date
10/18/2011Pubmed ID
21999574Pubmed Central ID
PMC3207968DOI
10.1186/1471-2458-11-807Scopus ID
2-s2.0-80053983056 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
BACKGROUND: The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens) in South Africa.
METHODS: Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse.
RESULTS: We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic.
CONCLUSIONS: Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.
Author List
Kalichman SC, Pinkerton SD, Carey MP, Cain D, Mehlomakulu V, Carey KB, Simbayi LC, Mwaba K, Harel OMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Alcohol Drinking
Cross-Sectional Studies
Female
HIV
HIV Infections
Heterosexuality
Humans
Logistic Models
Male
Risk Factors
Risk-Taking
Sexual Behavior
Sexual Partners
South Africa
Young Adult
