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Heterosexuals at risk for HIV: differences between private and commercial partners in sexual behaviour and condom use
C Hooykaas1, J van der Pligt, G J van Doornum
1Municipal Health Service of Amsterdam, Department of Public Health, The Netherlands.
Insights
High-risk sexual behaviors, including unprotected vaginal intercourse, are prevalent among heterosexuals with multiple partners, particularly commercial sex workers. Condom use is higher with commercial partners but insufficient to mitigate risk given the high number of partners.
Area of Science:
- Public Health
- Epidemiology
- Sexual Health
Background:
- High prevalence of HIV and STDs necessitates understanding sexual behaviors.
- Heterosexuals with multiple partners are a key demographic for STD/HIV transmission studies.
Purpose of the Study:
- To investigate the prevalence of HIV and STDs.
- To analyze sexual behaviors and condom use among heterosexuals with multiple partners.
- To differentiate risk between private and commercial sexual partnerships.
Main Methods:
- Longitudinal study of 193 women and 157 men recruited from an STD clinic.
- Participants had ≥5 heterosexual partners in 6 months, with no other AIDS risk factors.
- Data collected on sexual practices, partner types (private/commercial), and condom use.
Main Results:
- Prostitutes (71% of women) averaged 115 customers/month; male clients averaged 8 prostitute visits/4 months.
- Vaginal intercourse was common; anal contact was rare.
- Condom use was higher with commercial than private partners (P<0.01).
- Prostitutes had unprotected vaginal intercourse with an estimated 160 partners in 4 months.
Conclusions:
- Despite higher condom use with commercial partners, high partner numbers lead to significant unprotected exposure, especially for sex workers.
- Sexual behavior patterns and partner types significantly influence STD/HIV transmission risk.
- Targeted interventions are crucial for high-risk heterosexual populations.
Abstract:
To study the prevalence of HIV and other sexually transmitted diseases (STDs), sexual behaviour and condom use among heterosexuals, 193 women and 157 men entered a longitudinal study. Participants were recruited through an STD clinic, and had had five or more heterosexual partners in the preceding 6 months but had no other AIDS risk factors. Participants were divided in groups with respect to private and/or commercial sexual partners. One hundred and thirty-six (71%) women worked as prostitutes and had, on average, 115 customers a month, and 99 (63%) men had visited, on the average, eight prostitutes in the past 4 months. One hundred and seventy-one (89%) women (114 prostitutes) had had, on average, four partners, and 112 (78%) men (of whom 64 had visited prostitutes) had had, on average, seven private partners in the past 4 months. Vaginal intercourse was often or always reported by all participants whilst anal contact was seldom reported. Non-high-risk sexual techniques (for example, oro-oral, masturbation) were practised more frequently with private than with commercial partners (P less than 0.001). Although no differences were found in the frequency of practising high-risk sexual techniques (for example, vaginal, ano-genital), differences were found for frequency of condom use. Condom use during vaginal intercourse was reported more frequently with commercial than with private partners (P less than 0.01). However, if the number of partners is taken into account, prostitutes had unprotected vaginal intercourse with an estimated average number of 160 partners in 4 months, which is far more than customers (seven) and men and women with private partners only (four).(ABSTRACT TRUNCATED AT 250 WORDS)