 |
|
|
| |
Anal Sex Frequent--and Often Condom-Free--in
Global Female Sex Worker Study
|
| |
| |
HIV Research for Prevention (HIVR4P), October 21-25, 2018, Madrid
Mark Mascolini
More than 1 in 5 female sex workers (FSW) had anal intercourse in the past year, and almost 1 in 10 had anal sex in the past week, according to pooled analysis of 129 worldwide studies [1]. Condomless anal intercourse proved more frequent than condomless vaginal intercourse in this large study.
HIV passes between sex partners more readily during anal than vaginal sex, noted Imperial College London and University of California researchers who conducted this meta-analysis. As a result, anal sex may account for a meaningful proportion of new HIV infections in FSW and thus fuel the global epidemic. To get a global perspective on frequency of anal sex and condom use during anal sex in FSW, the research team conducted this systematic review and meta-analysis.
The investigators searched PubMed and Embase for January 1980 to January 2018 studies assessing the proportion of FSW practicing anal intercourse (prevalence) and/or number of anal sex acts (frequency). They also made pooled estimates of the proportion of FSW reporting condomless anal sex or condomless vaginal sex.
The 129 studies analyzed included 126 on anal sex prevalence and 13 on anal sex frequency. The highest number of studies took place in Asia (53), followed by Africa (33), Europe (23), North America (13), and South America (10). Sixty-four studies took place before 2003 and 65 studies from 2003 onward. Women's age averaged 27 or younger in 71 studies and 28 or older in 55 studies.
Pooled anal intercourse prevalence in the past year stood at 21.5%, while prevalence in the past week measured 8.7%. In other words, more than 1 in 5 FSW in these studies had anal sex in the past year and almost 1 in 10 had anal sex in the past week. Pooled lifetime anal sex prevalence was higher in studies done in 2003 or later than in earlier studies (19.2% versus 12.9%). These pooled estimates did not vary by continent or sex work location.
In an analysis that included women who reported no anal sex, the proportion of sex acts that were anal ranged from 2.4% to 15.9%.
A higher proportion of women practicing anal intercourse than vaginal intercourse reported condomless sex in the past week (pooled 46.4% versus 19.1%) or in the past month (pooled 61.3% versus 50.2%).
The researchers concluded that "heterosexual anal intercourse is practiced frequently by many FSW and is often unprotected by condoms and therefore likely contributes to HIV epidemics among this group." They proposed that anal sex prevalence may be even higher than they estimate here because many studies used face-to-face interviews and anal sex is widely stigmatized. The investigators recommended including advice on safe anal intercourse in interventions for FSW, as well as guidance on negotiating safe practices.
Reference
1. Owen BN, Elmes J, Harvey A, et al. What proportion of female sex workers practice anal intercourse and how frequently? A systematic review and meta-analysis. HIV Research for Prevention (HIVR4P), October 21-25, 2018, Madrid. Abstract P11.03.
|
| |
|
|
|
|
|
