Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort
Keywords: 
Kinshasa
Oral sex
Anal sex
Issue Date: 
2019
Publisher: 
Public Library of Science
OpenAIRE: 
Government of Spain (Fondo de Investigación en Salud-FIS) (PI16/01908 to GR/SC), the Government of Navarre (045-2015 to SC)
ISSN: 
1932-6203
Editorial note: 
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation: 
Carlos S, López-del Burgo C, Ndarabu A, Osorio A, Rico-Campà A, et al. (2019) Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort. PLOS ONE 14(1): e0210398
Abstract
Background Sexually 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. Methods OKAPI (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. Results Among 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. Conclusions Oral 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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