253158 Heterosexual anal intercourse and other sexual risk behaviors, outcomes of risk behavior and HIV-related health seeking behaviors among adults in STI clinics in South Africa: A cross-sectional study

Monday, October 31, 2011

Lauren Link, MPH, BA , HIV Center, New York Psychiatric Institute and Columbia University-Mailman School of Public Health, New York, NY
Elizabeth Kelvin, PhD , Epidemiology & Biostatistics, CUNY School of Public Health at Hunter College, New York, NY
Joanne E. Mantell, PhD, MSPH , HIV Center for Clinical and Behavioral Studies & Mailman School of Public Health, Columbia University, New York, NY
Susie Hoffman , HIV Center for Clinical and Behavioral Studies, NYSPI, New York, NY
Theresa Exner, PhD , HIV Center for Clinical and Behavioral Studies, Columbia University-Mailman School of Public Health, New York, NY
Landon Myer , School of Public Health& Family Medicine, University of Cape Town, Cape Town, South Africa
Background: Unprotected anal intercourse is a risk factor for HIV and other sexually transmitted infections (STIs) among men who have sex with men, but it can also be a risk factor among heterosexual partners. Previous studies looking at the practice of anal sex have primarily been conducted with homosexual and bisexual men. Yet, it is possible that those who practice heterosexual anal intercourse also participate in other risk behaviors, which would make this a high risk group worth targeting for intervention. Before such an intervention can be designed, additional information is needed about these risks. South African men and women who engage in heterosexual anal intercourse are more likely to also engage in other sexual risk behaviors (e.g. Number of partners, condom use, and transactional sex), have a higher number of STIs, and do not get tested for HIV. Methods: We recruited 1,914 clients from various STI clinics in Cape Town, South Africa. We conducted face to face interviews, and looked at the association of heterosexual anal intercourse with other sexual risk behaviors, STIs, and HIV testing using logistic regression.

Results: Overall, 6.2% of the sample had ever engaged in heterosexual anal intercourse. Having engaged in anal sex was not associated with any of the variables examined, and therefore the data do not support our hypothesis.

Discussion: An important subgroup of the sample engaged in heterosexual anal intercourse, but these participants were not more likely to engage in other risky behaviors either.

Learning Areas:
Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Social and behavioral sciences

Learning Objectives:
Describe the prevalence and associated sexual behaviors of anal intercourse among heterosexual STI clinic clients in Cape Town, South Africa Estimate the prevalence of anal sex, and other sexual risk behaviors among a sample of 1,914 heterosexual male and female STI clinic clients in Cape Town, South Africa, and Examine the association between heterosexual anal intercourse and other sexual risk behaviors, and outcomes (e.g. the number of times a client was told he/she had an STI), HIV health seeking behaviors (e.g. If a client got tested for HIV), perceptions of risk from anal sex (e.g. responding that someone will definitely get HIV if he/she had anal sex with an infected person), as well as demographic variables.

Keywords: Sexual Risk Behavior, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the primary author of this paper, as this was my dissertation for my Master's degree. I conducted and analyzed all of the descriptive statistics and regression models, constructed the literature review, and wrote the methods, results and discussion sections.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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