Heterosexual Anal Sex Among Female Drug Users: U.S. National Compared to Local Long Beach, California Data

Reynolds, Grace L.; Latimore, Amanda D.; Fisher, Dennis G.

doi:10.1007/s10461-007-9271-2

Cited by 24 publications

(21 citation statements)

References 31 publications

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“…In a nationally representative survey of adults in the United States lifetime AI was reported by about 40%, and AI in the past year by 20% of women aged 20-49 years. 1 Even higher prevalence has been recorded within sub-groups at “high risk” for HIV acquisition in the US: from 16% of substance-using women 2 and 19- 22% of women attending public STD clinics reporting AI within the past 3 months 3,4 and as high as 5 to 8% among female substance users in the past 30 days 5 . In South Africa, the prevalence of lifetime AI has been reported to be in excess of 40% among female sex workers 6 compared to only 5% among young women in the general population, 7 10% of women in the past 3 months in community settings 8 , and in the past month by 11% of women surveyed in alcohol serving establishments 9 – again with higher prevalence for “high risk groups”.…”

Section: Introductionmentioning

confidence: 99%

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Gorbach

Pines

Javanbakht

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background For women the order of penile insertion, condom use, and ejaculation by orifice during sexual events affects the probability of HIV transmission and design of HIV prevention methods. Methods From October 2006-June 2009, 431 women in Los Angeles and Baltimore in a rectal health study reported the sequence of penile insertion, condom use, and ejaculation by orifice location by computer assisted self-interview. Multinomial logistic regression identified predictors of condom use by orifice among women who reported vaginal intercourse (VI) during their last anal intercourse (AI) event. Results Of the 192 reporting on a last AI event, 96.3% (180/187) reported VI. Of these, 83.1% had VI before AI; 66.1% reported ejaculation during VI and 45.2% during AI. Only one third used a condom for both VI and AI, less than 10% for VI only or AI only; and half used no condoms. After adjusting for race, partner type, and substance use, compared to women who used condoms for both VI and AI at last AI, being older (units=5 years) (adjusted odds ratio [AOR]=0.76, 95% confidence interval [CI]: 0.60, 0.96), with serodiscordant partners (AOR=0.22, 95% CI: 0.08, 0.61) and HIV-positive with seroconcordant partners (AOR = 0.15; 95% CI: 0.04, 0.54) were inversely associated with non-condom use. Conclusions For most of the women in our study VI accompanied AI, with AI usually occurring after VI. This evidence for use of multiple orifices during the same sexual encounter and low use of condoms across orifices supports the need for a multi-compartment HIV prevention strategy.

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Section: Introductionmentioning

confidence: 99%

Order of Orifices

Gorbach

Pines

Javanbakht

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Estimates from the U.S. and U.K. suggest an average heterosexual anal intercourse prevalence of 11% (range = 2% to 39%) [1,2]. The highest rates have been found among female sex workers and patients at sexually transmitted infections (STI) clinics [3].…”

Section: Introductionmentioning

confidence: 99%

Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

et al. 2011

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BackgroundThe 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.MethodsCross-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.ResultsWe 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.ConclusionsAnal 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.

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“…Several studies have found that women who trade sex for money or drugs are more likely to engage in anal sex. 22, 23 Anal sex has also been associated with injection drug use, 22 partner’s injection drug use, 18, 22 crack use, 18, 24 and amphetamine use. 23 …”

Section: Introductionmentioning

confidence: 99%

Relationship Characteristics Associated With Anal Sex Among Female Drug Users

Mackesy‐Amiti¹,

McKirnan²,

Ouellet³

2010

Sexually Transmitted Diseases

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Background Anal sex is an important yet little studied HIV risk behavior for women. Methods Using information collected on recent sexual encounters, we examined the influence of sex partner and relationship characteristics on the likelihood of engaging in anal sex among women with a high risk of HIV infection. Results Anal sex was nearly three times more common among actively bisexual women (OR = 2.96, 95% CI 2.17 – 4.03). Women were more likely to have anal sex with partners who injected drugs (OR = 2.32, 95% CI 1.44 – 3.75), were not heterosexual (OR = 1.85, 95% CI 1.18 – 2.90), and with whom they exchanged money or drugs for sex (OR = 1.79, 95% CI 1.10 – 2.90). The likelihood of anal sex also increased with the number of nights sleeping together (OR = 1.15, 95% CI 1.06 – 1.24). In contrast, emotional closeness and social closeness were not associated with anal sex. Condom use during anal sex was uncommon, and did not vary according to partner or relationship characteristics. Conclusions Our findings support the need for HIV prevention interventions that target anal sex among heterosexuals, particularly in drug-using populations residing in neighborhoods with elevated levels of HIV prevalence.

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Heterosexual Anal Sex Among Female Drug Users: U.S. National Compared to Local Long Beach, California Data

Cited by 24 publications

References 31 publications

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Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa

Relationship Characteristics Associated With Anal Sex Among Female Drug Users

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