Prevalence and risk factors associated with female anal sex in the context of HIV/AIDS in the selected districts of Tanzania

Springer Science and Business Media LLC - Tập 10 - Trang 1-10 - 2017
Elizabeth H. Shayo1, Akili A. Kalinga2, Kesheni P. Senkoro1, Judith Msovela1, Erick J. Mgina2, Angela E. Shija1, Godlisten Materu2, Stella P. Kilima1, Leonard E. G. Mboera1, Julius J. Massaga1
1National Institute for Medical Research Headquarters, Dar es Salaam, Tanzania
2Tukuyu Medical Research Centre, Tukuyu, Tanzania

Tóm tắt

Female anal sex is a receptive type of sexual practice among heterosexual couples where the penis is inserted into the anus of a female partner. In the Western world, a number of studies and interventions have been carried out on anal sex among men due to its potential risks to HIV transmission. In African countries, including Tanzania, there is dearth of information on the risks inherent in practices associated with female anal sex in the general population. The objective of this study was to determine the prevalence and risk factors associated with female anal sex in fuelling HIV transmission in selected districts of Tanzania. This study was conducted in four districts of Tanzania of Kinondoni, Tanga Urban, Makete and Siha. Both quantitative and qualitative methods i.e. household interviews and focus group discussions were employed in data collection. Study participants included community members of aged 15 and above such as heads of the household, adolescents, bar workers and commercial sex workers. A total of 903 individuals were interviewed, 60.6% of whom were females. When respondents were asked to indicate whether they had ever been tempted to practise FAS, 167 (18.5%) reported to have been tempted in the past 12 months. Of these, 44 (26.3%) respondents had at least practised FAS. Risky practices associated with FAS were forced sex, multiple partners, frequency of engaging in FAS, low use of condoms during FAS, low rates of HIV testing among partakers, poor perception of the risks to acquire HIV through FAS and use of lubricants. In this population, the frequency of FAS practice was rather low. And yet, FAS practice attendant risk factors are likely to exacerbate HIV transmission. As such, there is a need for further exploratory studies to determine and document drivers of FAS. In addition, public health education should be provided with regard to the risks of contracting HIV associated with FAS practices.

Tài liệu tham khảo

Padian N, et al. Male to female transmission of human immunodeficiency virus. JAMA. 1987;258:788–90. Catania JA, et al. The continuing HIV epidemic among men who have sex with men. Am J Public Health. 2001;91(6):907–14. Auerbach J, Ruiz M, Kandathil S. HIV prevention for men who have sex with men. Washington DC: The foundation for AIDS research (AmfAR); 2006. Joseph A, Prince JH, Molly M, Britney W. Midwestern rural adolescents’ anal intercourse experience. J Rural Health. 2010;00:1–9. Shattock RJ, Moore JP. Inhibiting sexual transmission of HIV-1 infection. Nat Rev Microbiol. 2003;1(1):25–34. Royce RA, et al. Sexual transmission of HIV. N Engl J Med. 1997;336:1072–8. European Study Group on Heterosexual Transmission of HIV. Comparison of female to male and male to female transmission of HIV in 563 stable couples. BMJ. 1992;1992(304):809–13. M2010. Microbicides building bridges in HIV prevention: use of lubricant with oral sex could increase risks of HIV. HIV New research presented at the International Microbicides Conferences; 2010. Smith E, Udry JR. Coital and non-coital sexual behaviors of white and black adolescents. Am J Public Health. 1985;75:1200–3. Kazaura M, Masatu MC. Sexual practices among unmarried adolescents in Tanzania. BMC Public Health. 2009;9:373. doi:10.1186/1471-2458-9-373. Karim S. Anal sex and HIV transmission in women. Am J Public Health. 1998;88(8):1265–6. Schwandt M, Morris C, Ferguson A, Ngugi E, Moses S. Anal and dry sex in commercial sex work, and relation to risk for sexually transmitted infections and HIV in Meru, Kenya. Sex Transm Infect. 2006;82:392–6. Maswanya ES, Mutalemwa PP, Shayo EH, Kisoka WJ, Kilima SP, Mbilinyi DR, Munga MA, Kisinza WN. Drivers of HIV/AIDS epidemics in Tanzania mainland: Technical report, TACAIDS; 2010. Koblin BA, et al. Risk factors for HIV infection among men who have sex with men. Aids. 2006;20(5):731–9. Science D. Use of lubricants with anal sex could increase risk of HIV. 2010. http://www.sciencedaily.com/releases/2010/05/100525094900.htm. Ortiz HL, Garcia Torres MI. Internalized oppression and high-risk sexual practices among homosexual and bisexual males, Mexico. Rev Saude Publica. 2005;39(6):956–64. Ross MW, et al. High HIV seroprevalence, rectal STIs and risky sexual behaviour in men who have sex with men in Dar es Salaam and Tanga, Tanzania. BMJ Open. 2014;4(8):e006175. Dahoma M, Johnston LG, Hoplman A. HIV and related risk behavior among men who have sex with men in Zanzibar, Tanzania: results of a behavioral surveillance survey. AIDS Behav. 2011;15:186–92. Johnston LG, Holman A, Dahoma M. HIV risk and the overlap of injecting drug use and high-risk sexual behaviours among men who have sex with men in Zanzibar (Unguja), Tanzania. Int J Drug Pol. 2010;21:485–92. Cherie A, Berhane Y. Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia. BMC Public Health. 2012. doi:10.1186/1471-2458-12-5. Houston AM, Fang J, Husman D, Peralta L. More than just vaginal intercourse: anal intercourse and condom use patterns in the context of “main” and “casual” sexual relationships among urban minority adolescent females. J Pediatr Adolesc Gynecol. 2007;20:299–304. Adenike I, Olugbenga L. Sexual risk behavior among in-school adolescents in public secondary schools in a Southwestern City in Nigeria. Int J Health Res. 2009;2(3):243–51. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ. 2004;82(6):454–61. Green EC, Herling A. Paradigm shift and controversy in AIDS prevention. J Med. 2006;4(1):24. Baldwin JI, Baldwin JD. Heterosexual anal intercourse: an understudied, high-risk sexual behavior. Arch Sex Behav. 2000;29(4):357–73. Gross M, Holte SE, Marmor M, Mwatha A, Koblin BA, Mayer KH. Anal sex among HIV seronegative women at a high risk of HIV exposure, JAIDS. J Acquir Immune Defic Syndr. 2000;24:393–8. Prinstein MJ, Meade CS, Cohen GL. Adolescent oral sex, peer popularity, and perceptions of best friends’ sexual behavior. J Pediatr Psychol. 2003;28(4):243–9. Herbenick D, Reece M, Hansel D, Sanders S, Jozkowski K, Fortenberry JD. Association of lubricant use with women’s sexual pleasure, sexual satisfaction, and genital symptoms: a prospective daily diary study. J Sex Med. 2011;8(1):202–12. Reece M, Herbenick D, Sherwood-Puzzello C. Sexual health promotion and adult retail stores. J Sex Res. 2004;41:173–80. Herbenick D, Reece M. In-home sex toy party facilitators as sex educators: what questions are they asked and what makes them more “askable”? Am J Sex Educ. 2009;4:178–93. Halperin DT. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, part I. AIDS Patient Care STDs. 1999;13(12):717–30. CDC. Centers for Disease Control and Prevention Trends in HIV/AIDS Diagnoses—33 States, centers for disease control and prevention. 2005.