Sexual risk during pregnancy and postpartum periods among HIV-infected and –uninfected South African women: Implications for primary and secondary HIV prevention interventions

Davey, Dvora Joseph; Farley, Elise; Gomba, Yolanda; Coates, Thomas J.; Myer, Landon

doi:10.1371/journal.pone.0192982

Cited by 32 publications

(25 citation statements)

References 25 publications

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“…Seven studies did not indicate the study population age [35, 81, 100–102]. Overall, 46 studies included both male and females [35, 37–48, 51–56, 59, 64–66, 68, 70, 73, 78, 80, 84, 87, 92, 94, 101, 102, 111, 114, 120, 126–129, 134, 136], 51 studies included women/girls only [36, 49, 50, 57, 58, 60–63, 67, 69, 71, 72, 74, 76, 77, 79, 81–83, 85–91, 96–99, 105, 106, 109, 110, 112, 113, 115–119, 121, 132, 133, 135], and eight studies included men/boys only [75, 93, 95, 107, 108, 130, 131, 137].…”

Section: Resultsmentioning

confidence: 99%

“…Only six (two from South Africa and one each from Nigeria, Rwanda, Zambia and Zimbabwe) out of the 51 oral sex studies described the prevalence of reported oral sex as either giving or receiving oral sex [36, 37, 39, 69, 71, 72]. Most studies that reported on prevalence of oral sex were from South African region, among adolescents and young adults, and key affected populations (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Data on the prevalence of oral sex using other reporting periods came from 11 general population studies [40, 51, 52, 54, 56, 58, 59, 62, 69, 72, 134]. Three of these studies found that men/boys generally reported a higher prevalence of oral sex than in women/girls.…”

Section: Resultsmentioning

confidence: 99%

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Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review

et al. 2019

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review

et al. 2019

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“…Contraception has been one of the reasons described in the literature for practicing anal sex but there is no reason described for a higher prevalence of oral sex. A recent study carried out in South Africa among pregnant and postpartum women showed that during pregnancy 44% reported oral sex and 8% anal sex; and 49% and 11%, respectively at postpartum [9]. Teasdale et al found in a study carried out with pregnant women from Zimbabwe and South Africa, that pregnancy decreased sexual activity and high-risk sex, including anal sex [49].…”

Section: Discussionmentioning

confidence: 99%

Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort

et al. 2019

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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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“…For females of reproductive potential, sex that could lead to HIV infection may also result in pregnancy. Conversely, the perinatal period is a time of heightened risk for new HIV infection [2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of incident pregnancy in Phase 1 and 2a HIV-1 vaccine study participants does not support concern for adverse pregnancy or birth outcomes

Stranix‐Chibanda

Isaacs

et al. 2020

Preprint

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Background: Pregnancies occur during HIV-1 vaccine clinical trials, despite requirements for women of reproductive potential to use effective contraception. Deployment of an effective HIV-1 vaccine regimen will likely target adolescents and young adults and therefore safety for pregnant and breastfeeding women will need to be addressed. Methods: We performed a retrospective, cross-protocol analysis to identify and compare pregnancy outcomes reported in 53 Phase 1 and Phase 2a HIV-1 vaccine clinical trials conducted by the HIV Vaccine Trials Network (HVTN). Results: 2673 women of reproductive potential were identified and 193 pregnancies were reported. 39 of 53 (74%) studies had at least one pregnancy reported with an overall pregnancy rate of 3.15 per 100 woman-years (w-yr). While active contraception use was required during study participation, 13 of the 53 studies also contained a long-term follow up period during which pregnancy was no longer discouraged. The pregnancy rate during main study participation was 3.09 per 100 w-yr, while pregnancies occurred at a slightly greater rate in the long-term follow up period (3.22 per 100 w-yr). Adverse pregnancy outcomes were reported at similar rates between vaccinees and placebo recipients when vaccine vectors, adjuvant used, or geographic region were examined. Conclusion: Although there is considerable heterogeneity amongst the different vaccine trials, there appears to be no obvious indication of increased risk of adverse pregnancy or birth outcomes in these early phase HIV-1 vaccine studies. More complete data on pregnancy outcomes should be collected in a systematic fashion in early phase HIV-1 vaccine clinical trials to better inform subsequent efficacy trials.

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Sexual risk during pregnancy and postpartum periods among HIV-infected and –uninfected South African women: Implications for primary and secondary HIV prevention interventions

Cited by 32 publications

References 25 publications

Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review

Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review

Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort

A retrospective analysis of incident pregnancy in Phase 1 and 2a HIV-1 vaccine study participants does not support concern for adverse pregnancy or birth outcomes

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