The Experts below are selected from a list of 7431 Experts worldwide ranked by ideXlab platform

Susan Kippax - One of the best experts on this subject based on the ideXlab platform.

  • willingness to use hiv pre exposure prophylaxis and the likelihood of decreased condom use are both associated with unprotected Anal Intercourse and the perceived likelihood of becoming hiv positive among australian gay and bisexual men
    Sexually Transmitted Infections, 2012
    Co-Authors: Martin Holt, Dean Murphy, Denton Callander, Jeanne Ellard, Marsha Rosengarten, Susan Kippax
    Abstract:

    Objectives: To investigate willingness to use HIV preexposure prophylaxis (PrEP) and the likelihood of decreased condom use among Australian gay and bisexual men. Methods: A national, online cross-sectional survey was conducted in April to May 2011. Bivariate relationships were assessed with c2 or Fisher’s exact test. Multivariate logistic regression Analysis was performed to assess independent relationships with primary outcome variables. Results: Responses from 1161 HIV-negative and untested men were Analysed. Prior use of antiretroviral drugs as PrEP was rare (n¼6). Just over a quarter of the sample (n¼327; 28.2%) was classified as willing to use PrEP. Willingness to use PrEP was independently associated with younger age, having Anal Intercourse with casual partners (protected or unprotected), having fewer concerns about PrEP and perceiving oneself to be at risk of HIV. Among men who were willing to use PrEP (n¼327), only 26 men (8.0%) indicated that they would be less likely to use condoms if using PrEP. The likelihood of decreased condom use was independently associated with older age, unprotected Anal Intercourse with casual partners (UAIC) and perceiving oneself to be at increased risk of HIV. Conclusions: The Australian gay and bisexual men the authors surveyed were cautiously optimistic about PrEP. The minority of men who expressed willingness to use PrEP appear to be appropriate candidates, given that they are likely to report UAIC and to perceive themselves to be at risk of HIV.

  • predictors of hiv disclosure among untested hiv negative and hiv positive australian men who had Anal Intercourse with their most recent casual male sex partner
    Aids and Behavior, 2011
    Co-Authors: Martin Holt, Patrick Rawstorne, Heather Worth, Michael Bittman, Jennifer Wilkinson, Susan Kippax
    Abstract:

    We Analysed HIV disclosure between Australian men who have sex with men (MSM) who reported Anal Intercourse with their last casual male partner. Of 804 MSM included in the Analysis, 413 reported HIV disclosure and 391 reported no disclosure. After identifying bivariate associations with HIV disclosure, we developed three models of HIV disclosure (one for untested, one for HIV-negative and one for HIV-positive MSM). A range of factors was found to be associated with HIV disclosure. Having previously had sex with the last casual male partner and expecting HIV-negative and HIV-positive men to disclose before sex were predictors of HIV disclosure shared by more than one serostatus group. As unprotected Anal Intercourse was more common among MSM who disclosed (across all serostatus groups), we suggest caution should be exercised before encouraging HIV disclosure as a prevention strategy. Nondisclosure remains more strongly associated with safe sex among Australian MSM.

  • increases in unprotected Anal Intercourse with serodiscordant casual partners among hiv negative gay men in sydney
    Aids and Behavior, 2009
    Co-Authors: Iryna Zablotska, Garrett Prestage, June Crawford, Andrew E. Grulich, Fengyi Jin, John Imrie, Susan Kippax
    Abstract:

    Prevalence of unprotected Anal Intercourse between casual male partners (UAIC) has been increasing worldwide. We explored trends in serodiscordant UAIC and the associated factors among gay men in Sydney. Proportions of HIV-positive and negative men with serodiscordant casual partners increased during 2003-2006. Prevalence of serodiscordant UAIC increased among HIV-negative men. Age, number of partners, seeking partners online, drug use and esoteric practices were associated with serodiscordant UAIC. Increases in serodiscordant UAIC may be related to growing disclosure. These findings do not indicate a core group of high-risk men. More research is needed about the context in which serodiscordant UAIC happens.

  • gay men s current practice of hiv seroconcordant unprotected Anal Intercourse serosorting or seroguessing
    Aids Care-psychological and Socio-medical Aspects of Aids\ hiv, 2009
    Co-Authors: Iryna Zablotska, Garrett Prestage, June Crawford, Andrew E. Grulich, Fengyi Jin, John Imrie, Patrick Rawstorne, Susan Kippax
    Abstract:

    Abstract We explored seroguessing (serosorting based on the assumption of HIV seroconcordance) and casual unprotected Anal Intercourse (UAIC) associated with seroguessing. The ongoing Positive Health and Health in Men cohorts, Australia, provided data for trends in seroconcordant UAIC and HIV disclosure to sex partners. In event-level Analyses, we used log-binomial regression adjusted for within-individual correlation and estimated prevalence rate ratios (PRRs) and 95% confidence intervals (95% CIs) for the association between the knowledge of a casual partner's seroconcordance and UAIC. UAIC and HIV disclosure significantly increased during 2001–2006. HIV-positive men knew partners were seroconcordant in 54% and assumed it in 13% of sex encounters (42 and 17% among HIV-negative men). Among HIV-positive men, the likelihood of UAIC was higher when a partner's status was known (Adjusted PRR = 5.17, 95% CI: 3.82–7.01) and assumed seroconcordant because of seroguessing (Adjusted PRR = 3.70, 95% CI: 2.56–5.35)...

  • Unprotected Anal Intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men.
    AIDS, 2009
    Co-Authors: Fengyi Jin, Susan Kippax, Garrett Prestage, June Crawford, Iryna Zablotska, John Imrie, John M. Kaldor, Andrew E. Grulich
    Abstract:

    Objective A range of risk reduction behaviours in which homosexual men practise unprotected Anal Intercourse (UAI) has been described. We aimed to assess the extent of any reduction in HIV risk associated with these behaviours.

Jocelyn Elmes - One of the best experts on this subject based on the ideXlab platform.

  • patterns and trajectories of Anal Intercourse practice over the life course among us women at risk of hiv
    The Journal of Sexual Medicine, 2020
    Co-Authors: Branwen N Owen, Jocelyn Elmes, Rebecca F. Baggaley, Mathieu Maheugiroux, Adaora A Adimora, Catalina Ramirez, Andrew Edmonds, Kemi Sosanya, Tonya N Taylor
    Abstract:

    Abstract Introduction Condomless Anal Intercourse (AI) confers a far greater likelihood of HIV transmission than condomless vaginal Intercourse (VI). However, little is known about AI practice over the life course of women, to what extent AI practice is condom-protected, and whether it is associated with other HIV risk behaviors. We aim to describe longitudinal AI practice among HIV-seronegative women and to identify subgroups with distinct trajectories of AI practice. Methods Using data from the Women's Interagency HIV Study, an observational cohort of US women with or at risk for HIV, we described AI practice among HIV-seronegative participants. Group-based trajectory modeling was used to identify distinct AI trajectories. We used multinomial regression to examine associations between baseline characteristics and trajectory group membership. Results A third of the 1,085 women in our sample reported any AI over follow-up (median follow-up = 14 years). AI decreased more sharply with age compared to VI. Consistent condom use during AI was low: twice the proportion of women never reported using condoms consistently during AI compared to during VI. 5 trajectory groups were identified: AI & VI persistors (N = 75) practiced AI and VI consistently over follow-up (AI & VI desistors (N = 169) tended to practice AI and VI when young only, while VI persistors (N = 549), VI desistors (N = 167), and AI & VI inactives (N = 125) reported varying levels of VI practice, but little AI. AI & VI persistors reported multiple male partners and exchange sex at more visits than other groups. Women who identified as bisexual/lesbian (vs heterosexual), who had ever experienced physical and sexual violence (vs never), and/or who reported above the median number of lifetime male sex partners (vs median or below) had approximately twice the odds of being AI & VI persistors than being VI persistors. Conclusions We identified a small subgroup of women who practice AI and report inconsistent condom use along with other risk behaviors throughout the life course; they may therefore particularly benefit from ongoing access to HIV prevention services including pre-exposure prophylaxis. Owen BN, Baggaley RF, Maheu-Giroux M, et al. Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV. J Sex Med 2020;17:1629–1642.

  • Increases in HIV Incidence Following Receptive Anal Intercourse Among Women: A Systematic Review and Meta-Analysis
    AIDS and Behavior, 2020
    Co-Authors: James Stannah, Jocelyn Elmes, Romain Silhol, Barbara Shacklett, Peter Anton, Ariane Van Der Straten, Ian Mcgowan, Branwen Owen, Dobromir Dimitrov, Rebecca F. Baggaley
    Abstract:

    Receptive Anal Intercourse (RAI) carries a greater per-act risk of HIV acquisition than receptive vaginal Intercourse (RVI) and may influence HIV epidemics driven by heterosexual sex. This systematic review explores the association between RAI and incident HIV among women, globally. We searched Embase and Medline through September 2018 for longitudinal studies reporting crude (cRR) or adjusted (aRR) relative risks of HIV acquisition by RAI practice among women. Of 27,563 articles identified, 17 eligible studies were included. We pooled independent study estimates using random-effects models. Women reporting RAI were more likely to acquire HIV than women not reporting RAI (pooled cRR = 1.56 95% CI 1.03–2.38, N = 18, I^2 = 72%; pooled aRR = 2.23, 1.01–4.92, N = 5, I^2 = 70%). In subgroup Analyses the association was lower for women in Africa (pooled cRR = 1.16, N = 13, I^2 = 21%) than outside Africa (pooled cRR = 4.10, N = 5, I^2 = 79%) and for high-risk (pooled aRR = 1.69, N = 4, I^2 = 63%) than general-risk women (pooled aRR = 8.50, N = 1). Interview method slightly influenced cRR estimates ( p value = 0.04). In leave-one-out sensitivity Analyses pooled estimates were generally robust to removing individual study estimates. Main limitations included poor exposure definition, incomplete adjustment for confounders, particularly condom use, and use of non-confidential interview methods. More and better data are needed to explain differences in risk by world region and risk population. Women require better counselling and greater choice in prevention modalities that are effective during RVI and RAI.

  • what proportion of female sex workers practise Anal Intercourse and how frequently a systematic review and meta Analysis
    Aids and Behavior, 2020
    Co-Authors: Branwen N Owen, Jocelyn Elmes, Zara Shubber, Ailsa R. Butler, Romain Silhol, Rebecca F. Baggaley, Amy Harvey, Peter A Anton, Barbara Shacklett
    Abstract:

    HIV is more efficiently acquired during receptive Anal Intercourse (AI) compared to vaginal Intercourse (VI) and may contribute substantially to female sex workers’ (FSW) high HIV burden. We aim to determine how common and frequent AI is among FSW globally. We searched PubMed, Embase and PsycINFO for studies reporting the proportion of FSW practising AI (prevalence) and/or the number of AI acts (frequency) worldwide from 01/1980 to 10/2018. We assessed the influence of participant and study characteristics on AI prevalence (e.g. continent, study year and interview method) through sub-group Analysis. Of 15,830 identified studies, 131 were included. Nearly all (N = 128) reported AI prevalence and few frequency (N = 13), over various recall periods. Most studies used face-to-face interviews (N = 111). Pooled prevalences varied little by recall period (lifetime: 15.7% 95%CI 12.2–19.3%, N = 30, I2 = 99%; past month: 16.2% 95%CI 10.8–21.6%, N = 18, I2 = 99%). The pooled proportion of FSW reporting < 100% condom use tended to be non-significantly higher during AI compared to during VI (e.g. any unprotected VI: 19.1% 95%CI 1.7–36.4, N = 5 and any unprotected AI: 46.4% 95%CI 9.1–83.6, N = 5 in the past week). Across all study participants, between 2.4 and 15.9% (N = 6) of all Intercourse acts (AI and VI) were Anal. Neither AI prevalence nor frequency varied substantially by any participant or study characteristics. Although varied, AI among FSW is generally common, inconsistently protected with condoms and practiced sufficiently frequently to contribute substantially to HIV acquisition in this risk group. Interventions to address barriers to condom use are needed.

  • What Proportion of Female Sex Workers Practise Anal Intercourse and How Frequently? A Systematic Review and Meta-Analysis
    AIDS and Behavior, 2019
    Co-Authors: Branwen Nia Owen, Jocelyn Elmes, Zara Shubber, Ailsa R. Butler, Romain Silhol, Barbara Shacklett, Peter Anton, Rebecca F. Baggaley, Amy Harvey, Ariane Van Der Straten
    Abstract:

    HIV is more efficiently acquired during receptive Anal Intercourse (AI) compared to vaginal Intercourse (VI) and may contribute substantially to female sex workers’ (FSW) high HIV burden. We aim to determine how common and frequent AI is among FSW globally. We searched PubMed, Embase and PsycINFO for studies reporting the proportion of FSW practising AI (prevalence) and/or the number of AI acts (frequency) worldwide from 01/1980 to 10/2018. We assessed the influence of participant and study characteristics on AI prevalence (e.g. continent, study year and interview method) through sub-group Analysis. Of 15,830 identified studies, 131 were included. Nearly all (N = 128) reported AI prevalence and few frequency (N = 13), over various recall periods. Most studies used face-to-face interviews (N = 111). Pooled prevalences varied little by recall period (lifetime: 15.7% 95%CI 12.2–19.3%, N = 30, I^2 = 99%; past month: 16.2% 95%CI 10.8–21.6%, N = 18, I^2 = 99%). The pooled proportion of FSW reporting

  • how common and frequent is heterosexual Anal Intercourse among south africans a systematic review and meta Analysis
    Journal of the International AIDS Society, 2017
    Co-Authors: Branwen N Owen, Jocelyn Elmes, Romain Silhol, Barbara Shacklett, Rebecca F. Baggaley, Ian Mcgowan, Que Dang, Edith Swann, Ariane Van Der Straten, Marieclaude Boily
    Abstract:

    Background : HIV is transmitted more effectively during Anal Intercourse (AI) than vaginal Intercourse (VI). However, patterns of heterosexual AI practice and its contribution to South Africa’s generalized epidemic remain unclear. We aimed to determine how common and frequent heterosexual AI is in South Africa. Methods : We searched for studies reporting the proportion practising heterosexual AI (prevalence) and/or the number of AI and unprotected AI (UAI) acts (frequency) in South Africa from 1990 to 2015. Stratified random-effects meta-Analysis by subgroups was used to produce pooled estimates and assess the influence of participant and study characteristics on AI prevalence. We also estimated the fraction of all sex acts which were AI or UAI and compared condom use during VI and AI. Results : Of 41 included studies, 31 reported on AI prevalence and 14 on frequency, over various recall periods. AI prevalence was high across different recall periods for sexually active general-risk populations (e.g. lifetime = 18.4% [95%CI:9.4–27.5%], three-month = 20.3% [6.1–34.7%]), but tended to be even higher in higher-risk populations such as STI patients and female sex workers (e.g. lifetime = 23.2% [0.0–47.4%], recall period not stated = 40.1% [36.2–44.0%]). Prevalence was higher in studies using more confidential interview methods. Among general and higher-risk populations, 1.2–40.0% and 0.7–21.0% of all unprotected sex acts were UAI, respectively. AI acts were as likely to be condom protected as vaginal acts. Discussion : Reported heterosexual AI is common but variable among South Africans. Nationally and regionally representative sexual behaviour studies that use standardized recall periods and confidential interview methods, to aid comparison across studies and minimize reporting bias, are needed. Such data could be used to estimate the extent to which AI contributes to South Africa’s HIV epidemic. Keywords : Anal Intercourse; heterosexual; sexual behaviour; South Africa (Published: 12 January 2017) To access the supplementary material to this article please see Supplementary Files under Article Tools online. Citation: Owen BN et al. Journal of the International AIDS Society 2017, 20:21162 http://www.jiasociety.org/index.php/jias/article/view/21162 | http://dx.doi.org/10.7448/IAS.20.1.21162

Rebecca F. Baggaley - One of the best experts on this subject based on the ideXlab platform.

  • patterns and trajectories of Anal Intercourse practice over the life course among us women at risk of hiv
    The Journal of Sexual Medicine, 2020
    Co-Authors: Branwen N Owen, Jocelyn Elmes, Rebecca F. Baggaley, Mathieu Maheugiroux, Adaora A Adimora, Catalina Ramirez, Andrew Edmonds, Kemi Sosanya, Tonya N Taylor
    Abstract:

    Abstract Introduction Condomless Anal Intercourse (AI) confers a far greater likelihood of HIV transmission than condomless vaginal Intercourse (VI). However, little is known about AI practice over the life course of women, to what extent AI practice is condom-protected, and whether it is associated with other HIV risk behaviors. We aim to describe longitudinal AI practice among HIV-seronegative women and to identify subgroups with distinct trajectories of AI practice. Methods Using data from the Women's Interagency HIV Study, an observational cohort of US women with or at risk for HIV, we described AI practice among HIV-seronegative participants. Group-based trajectory modeling was used to identify distinct AI trajectories. We used multinomial regression to examine associations between baseline characteristics and trajectory group membership. Results A third of the 1,085 women in our sample reported any AI over follow-up (median follow-up = 14 years). AI decreased more sharply with age compared to VI. Consistent condom use during AI was low: twice the proportion of women never reported using condoms consistently during AI compared to during VI. 5 trajectory groups were identified: AI & VI persistors (N = 75) practiced AI and VI consistently over follow-up (AI & VI desistors (N = 169) tended to practice AI and VI when young only, while VI persistors (N = 549), VI desistors (N = 167), and AI & VI inactives (N = 125) reported varying levels of VI practice, but little AI. AI & VI persistors reported multiple male partners and exchange sex at more visits than other groups. Women who identified as bisexual/lesbian (vs heterosexual), who had ever experienced physical and sexual violence (vs never), and/or who reported above the median number of lifetime male sex partners (vs median or below) had approximately twice the odds of being AI & VI persistors than being VI persistors. Conclusions We identified a small subgroup of women who practice AI and report inconsistent condom use along with other risk behaviors throughout the life course; they may therefore particularly benefit from ongoing access to HIV prevention services including pre-exposure prophylaxis. Owen BN, Baggaley RF, Maheu-Giroux M, et al. Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV. J Sex Med 2020;17:1629–1642.

  • Increases in HIV Incidence Following Receptive Anal Intercourse Among Women: A Systematic Review and Meta-Analysis
    AIDS and Behavior, 2020
    Co-Authors: James Stannah, Jocelyn Elmes, Romain Silhol, Barbara Shacklett, Peter Anton, Ariane Van Der Straten, Ian Mcgowan, Branwen Owen, Dobromir Dimitrov, Rebecca F. Baggaley
    Abstract:

    Receptive Anal Intercourse (RAI) carries a greater per-act risk of HIV acquisition than receptive vaginal Intercourse (RVI) and may influence HIV epidemics driven by heterosexual sex. This systematic review explores the association between RAI and incident HIV among women, globally. We searched Embase and Medline through September 2018 for longitudinal studies reporting crude (cRR) or adjusted (aRR) relative risks of HIV acquisition by RAI practice among women. Of 27,563 articles identified, 17 eligible studies were included. We pooled independent study estimates using random-effects models. Women reporting RAI were more likely to acquire HIV than women not reporting RAI (pooled cRR = 1.56 95% CI 1.03–2.38, N = 18, I^2 = 72%; pooled aRR = 2.23, 1.01–4.92, N = 5, I^2 = 70%). In subgroup Analyses the association was lower for women in Africa (pooled cRR = 1.16, N = 13, I^2 = 21%) than outside Africa (pooled cRR = 4.10, N = 5, I^2 = 79%) and for high-risk (pooled aRR = 1.69, N = 4, I^2 = 63%) than general-risk women (pooled aRR = 8.50, N = 1). Interview method slightly influenced cRR estimates ( p value = 0.04). In leave-one-out sensitivity Analyses pooled estimates were generally robust to removing individual study estimates. Main limitations included poor exposure definition, incomplete adjustment for confounders, particularly condom use, and use of non-confidential interview methods. More and better data are needed to explain differences in risk by world region and risk population. Women require better counselling and greater choice in prevention modalities that are effective during RVI and RAI.

  • what proportion of female sex workers practise Anal Intercourse and how frequently a systematic review and meta Analysis
    Aids and Behavior, 2020
    Co-Authors: Branwen N Owen, Jocelyn Elmes, Zara Shubber, Ailsa R. Butler, Romain Silhol, Rebecca F. Baggaley, Amy Harvey, Peter A Anton, Barbara Shacklett
    Abstract:

    HIV is more efficiently acquired during receptive Anal Intercourse (AI) compared to vaginal Intercourse (VI) and may contribute substantially to female sex workers’ (FSW) high HIV burden. We aim to determine how common and frequent AI is among FSW globally. We searched PubMed, Embase and PsycINFO for studies reporting the proportion of FSW practising AI (prevalence) and/or the number of AI acts (frequency) worldwide from 01/1980 to 10/2018. We assessed the influence of participant and study characteristics on AI prevalence (e.g. continent, study year and interview method) through sub-group Analysis. Of 15,830 identified studies, 131 were included. Nearly all (N = 128) reported AI prevalence and few frequency (N = 13), over various recall periods. Most studies used face-to-face interviews (N = 111). Pooled prevalences varied little by recall period (lifetime: 15.7% 95%CI 12.2–19.3%, N = 30, I2 = 99%; past month: 16.2% 95%CI 10.8–21.6%, N = 18, I2 = 99%). The pooled proportion of FSW reporting < 100% condom use tended to be non-significantly higher during AI compared to during VI (e.g. any unprotected VI: 19.1% 95%CI 1.7–36.4, N = 5 and any unprotected AI: 46.4% 95%CI 9.1–83.6, N = 5 in the past week). Across all study participants, between 2.4 and 15.9% (N = 6) of all Intercourse acts (AI and VI) were Anal. Neither AI prevalence nor frequency varied substantially by any participant or study characteristics. Although varied, AI among FSW is generally common, inconsistently protected with condoms and practiced sufficiently frequently to contribute substantially to HIV acquisition in this risk group. Interventions to address barriers to condom use are needed.

  • Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV
    2020
    Co-Authors: Bn Owen, Rebecca F. Baggaley, Adaora A Adimora, Catalina Ramirez, Andrew Edmonds, Kemi Sosanya, M Maheu-giroux, J Elmes, T Taylor, M Plankey
    Abstract:

    Introduction: Condomless Anal Intercourse (AI) confers a far greater likelihood of HIV transmission than condomless vaginal Intercourse (VI). However, little is known about AI practice over the life course of women, to what extent AI practice is condom-protected, and whether it is associated with other HIV risk behaviors. We aim to describe longitudinal AI practice among HIV-seronegative women and to identify subgroups with distinct trajectories of AI practice. Methods: Using data from the Women's Interagency HIV Study, an observational cohort of US women with or at risk for HIV, we described AI practice among HIV-seronegative participants. Group-based trajectory modeling was used to identify distinct AI trajectories. We used multinomial regression to examine associations between baseline characteristics and trajectory group membership. Results: A third of the 1,085 women in our sample reported any AI over follow-up (median follow-up = 14 years). AI decreased more sharply with age compared to VI. Consistent condom use during AI was low: twice the proportion of women never reported using condoms consistently during AI compared to during VI. 5 trajectory groups were identified: AI & VI persistors (N = 75) practiced AI and VI consistently over follow-up (AI & VI desistors (N = 169) tended to practice AI and VI when young only, while VI persistors (N = 549), VI desistors (N = 167), and AI & VI inactives (N = 125) reported varying levels of VI practice, but little AI. AI & VI persistors reported multiple male partners and exchange sex at more visits than other groups. Women who identified as bisexual/lesbian (vs heterosexual), who had ever experienced physical and sexual violence (vs never), and/or who reported above the median number of lifetime male sex partners (vs median or below) had approximately twice the odds of being AI & VI persistors than being VI persistors. Conclusions: We identified a small subgroup of women who practice AI and report inconsistent condom use along with other risk behaviors throughout the life course; they may therefore particularly benefit from ongoing access to HIV prevention services including pre-exposure prophylaxis

  • What Proportion of Female Sex Workers Practise Anal Intercourse and How Frequently? A Systematic Review and Meta-Analysis
    AIDS and Behavior, 2019
    Co-Authors: Branwen Nia Owen, Jocelyn Elmes, Zara Shubber, Ailsa R. Butler, Romain Silhol, Barbara Shacklett, Peter Anton, Rebecca F. Baggaley, Amy Harvey, Ariane Van Der Straten
    Abstract:

    HIV is more efficiently acquired during receptive Anal Intercourse (AI) compared to vaginal Intercourse (VI) and may contribute substantially to female sex workers’ (FSW) high HIV burden. We aim to determine how common and frequent AI is among FSW globally. We searched PubMed, Embase and PsycINFO for studies reporting the proportion of FSW practising AI (prevalence) and/or the number of AI acts (frequency) worldwide from 01/1980 to 10/2018. We assessed the influence of participant and study characteristics on AI prevalence (e.g. continent, study year and interview method) through sub-group Analysis. Of 15,830 identified studies, 131 were included. Nearly all (N = 128) reported AI prevalence and few frequency (N = 13), over various recall periods. Most studies used face-to-face interviews (N = 111). Pooled prevalences varied little by recall period (lifetime: 15.7% 95%CI 12.2–19.3%, N = 30, I^2 = 99%; past month: 16.2% 95%CI 10.8–21.6%, N = 18, I^2 = 99%). The pooled proportion of FSW reporting

Pamina M Gorbach - One of the best experts on this subject based on the ideXlab platform.

  • is intimate partner and client violence associated with condomless Anal Intercourse and hiv among male sex workers in lima peru
    Aids and Behavior, 2016
    Co-Authors: Paul E George, Angela M Bayer, Patricia J Garcia, Jose E Perezlu, Jessica G Burke, Thomas J Coates, Pamina M Gorbach
    Abstract:

    Violence experience can increase HIV risk behaviors; however, literature is scarce on violence among male sex workers (MSWs) globally. In 2014, 210 Peruvian MSWs (median age 24.9) were interviewed about their experience of physical, emotional, and sexual violence and condom use with non-paying intimate partners and clients and were tested for HIV. Multivariable models examined relationships between violence in the past 6 months, condomless Anal Intercourse (CLAI) in the past 3 months and HIV infection. HIV infection (24 %), CLAI (43 %), being a violence victim (42 %) and perpetrator (39 %) were common. In separate multivariable models, being a violence victim [adjusted prevalence ratio aPR = 1.49 (95 % CI 1.09-2.03)] and perpetrator [aPR = 1.39 (1.03-1.87)] were associated with CLAI. Further, being a victim [aPR = 1.65 (1.04-2.62)] was associated with HIV infection. Violence, which was significantly associated with CLAI and HIV infection, is common among Peruvian MSWs, reinforcing the importance of violence awareness and prevention as HIV risk-reduction strategies.

  • order of orifices sequence of condom use and ejaculation by orifice during Anal Intercourse among women implications for hiv transmission
    Journal of Acquired Immune Deficiency Syndromes, 2014
    Co-Authors: Pamina M Gorbach, Marjan Javanbakht, Robert E. Weiss, Edward J. Fuchs, Ross D Cranston, Heather A Pines, Robin A Jeffries, Marjan Hezerah, Stephen J Brown, Alen Voskanian
    Abstract:

    Author(s): Gorbach, Pamina M; Pines, Heather; Javanbakht, Marjan; Weiss, Robert E; Jeffries, Robin; Cranston, Ross D; Fuchs, Edward J; Hezerah, Marjan; Brown, Stephen; Voskanian, Alen; Anton, Peter | Abstract: For women, the order of penile insertion, condom use, and ejaculation by orifice during sexual events affects the probability of HIV transmission and design of HIV prevention methods.From October 2006 to June 2009, 431 women in Los Angeles and Baltimore in a rectal health study reported the sequence of penile insertion, condom use, and ejaculation by orifice location by computer-assisted self-interview. Multinomial logistic regression identified predictors of condom use by orifice among women who reported vaginal Intercourse (VI) during their last Anal Intercourse (AI) event.Of the 192 reporting on a last AI event, 96.3% (180/187) reported VI. Of these, 83.1% had VI before AI. Including the 36% who ejaculated in both the rectum and vagina, 66% report any ejaculation in the vagina and 45% in the rectum. One-third used a condom for both VI and AI, l10% for VI only or AI only, and half used no condoms. After adjusting for race, partner type, and substance use, compared with women who used condoms for both VI and AI at last AI, being older (units = 5 years) [adjusted odds ratio (AOR) = 0.76; 95% confidence interval (CI): 0.60 to 0.96], with serodiscordant partners (AOR = 0.22; 95% CI: 0.08 to 0.61), and HIV-positive with seroconcordant partners (AOR = 0.15; 95% CI: 0.04 to 0.54) were associated with not using condoms.For most of the women in our study VI accompanied AI, with AI usually occurring after VI. This evidence for use of multiple orifices during the same sexual encounter and low use of condoms across orifices supports the need for a multicompartment HIV prevention strategy.

  • prevalence and types of rectal douches used for Anal Intercourse results from an international survey
    BMC Infectious Diseases, 2014
    Co-Authors: Marjan Javanbakht, Marcandre Leblanc, Shauna Stahlman, James Pickett, Pamina M Gorbach
    Abstract:

    Rectal products used with Anal Intercourse (AI) may facilitate transmission of STIs/HIV. However, there is limited data on rectal douching behavior in populations practicing AI. We examined the content, types of products, rectal douching practices and risk behaviors among those reporting AI. From August 2011 to May 2012, 1,725 women and men reporting receptive AI in the past 3 months completed an internet-based survey on rectal douching practices. The survey was available in English, French, German, Mandarin, Portuguese, Russian, Spanish, and Thai and included questions on sexual behaviors associated with AI including rectal douching. Differences by rectal douching practices were evaluated using chi-square methods and associations between reported douching practices and other factors including age and reported STI history were evaluated using logistic regression Analysis. Respondents represented 112 countries, were mostly male (88%), and from North America (55%) or Europe (22%). Among the 1,339 respondents (66%) who reported rectal douching, most (83%) reported always/almost always douching before receptive AI. The majority of rectal douchers reported using non-commercial/homemade products (93%), with water being the most commonly used product (82%). Commercial products were used by 31%, with the most common product being saline-based (56%). Rectal douching varied by demographic and risk behaviors. The prevalence of rectal douching was higher among men (70% vs. 32%; p-value < .01), those reporting substance-use with sex (74% vs. 46%; p-value < .01), and those reporting an STI in the past year (69% vs. 57% p-value < .01) or ever testing HIV-positive (72% vs. 53%; p-value < .01). In multivariable Analysis, adjusting for age, gender, region, condom and lubricant use, substance use, and HIV-status, douchers had a 74% increased odds of reporting STI in the past year as compared to non-douchers [adjusted odds ratio (AOR) = 1.74; 95% CI 1.01-3.00]. Given that rectal douching before receptive AI is common and because rectal douching was associated with other sexual risk behaviors the contribution of this practice to the transmission and acquisition of STIs including HIV may be important.

  • preference and practices relating to lubricant use during Anal Intercourse implications for rectal microbicides
    Sexual Health, 2010
    Co-Authors: Marjan Javanbakht, Pamina M Gorbach, Ryan Murphy, Marcandre Leblanc, Jim Pickett
    Abstract:

    Background: The importance of the acceptability of rectal microbicides for HIV and sexually transmissible infections (STIs) prevention is widely recognised. Given relatively consistent use of lubricants for Anal Intercourse (AI) and the potential for lubricant-like rectal microbicides, understanding barriers to lubricant use may help inform hurdles likely to be encountered once a rectal microbicide becomes available. Methods: We conducted an internet-based survey using a 25-item questionnaire to assess AI and lubricant use, including lubricant preferences and barriers to use. Results: The majority of the 6124 respondents who reported AI were male (93%), 25 years or older (80%) and from North America (70%). Consistent condom use during AI was reported by a minority (35%) and consistent lubricant use was reported by over half of respondents. Reasons for non-use differed by age and region. Among men, those <25 years were more likely to report barriers around cost compared with those 45 and older (odds ratio (OR) = 6.64; 95% confidence interval (CI) 3.14–14.03). European men (OR = 1.92; 95% CI 1.50–2.45), Latin American women (OR = 3.69; 95% CI 1.27–10.75) and Asian women (OR = 4.04; 95% CI 1.39–11.78) were more likely to report sexual preference as a reason for non-use. Conclusions: Rectal lubricants are widely used, but barriers to use vary by age and region for dry sex. A lubricant-like rectal microbicide would potentially be acceptable and such a product may be useful as a method of HIV prevention. However, targeted marketing and educational approaches may be needed to enhance use and acceptability of such a product.

  • Anal Intercourse among young heterosexuals in three sexually transmitted disease clinics in the United States.
    Sexually Transmitted Diseases, 2009
    Co-Authors: Pamina M Gorbach, Kristen L. Hess, Bradley P. Stoner, David H. Martin, K. Holmes
    Abstract:

    Objective:To examine factors associated with heterosexual Anal Intercourse (AI).Methods:Between 2001 and 2004, 1084 heterosexual adults aged 18 to 26 attending public sexually transmitted disease clinics in Seattle, New Orleans, and St Louis were interviewed using computer-assisted self interview an

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  • Anal Intercourse among female sex workers in cote d ivoire prevalence determinants and model based estimates of the population level impact on hiv transmission
    American Journal of Epidemiology, 2018
    Co-Authors: Mathieu Maheugiroux, Stefan Baral, Juan F Vesga, Daouda Diouf, Souleymane Diabate, Michel Alary, Kouame Abo, Marieclaude Boily
    Abstract:

    Current evidence suggests that Anal Intercourse (AI) during sex work is common in sub-Saharan Africa, but there have been few studies in which the contribution of heterosexual AI to human immunodeficiency virus (HIV) epidemics has been investigated. Using a respondent-driven sampling survey of female sex workers (FSWs; n = 466) in Abidjan, Cote d’Ivoire, in 2014, we estimated AI prevalence and frequency. Poisson regressions were used to identify AI determinants. Approximately 20% of FSWs engaged in AI during a normal week (95% confidence interval: 15, 26). Women who performed AI were generally younger, had been selling sex for longer, were born in Cote d’Ivoire, and reported higher sex-work income, more frequent sex in public places, and violence from clients than women not reporting AI. Condom use was lower, condom breakage/slippage more frequent, and use of water-based lubricants was less frequently reported for AI than for vaginal Intercourse. Using a dynamic transmission model, we estimated that 22% (95% credible interval: 11, 37% of new HIV infections could have been averted among FSWs during 2000–2015 if AI had been substituted for vaginal Intercourse. Despite representing a small fraction of all sex acts, AI is an underestimated source of HIV transmission. Increasing availability and uptake of condoms, lubricants, and pre-exposure prophylaxis for women engaging in AI could help mitigate HIV risk.

  • how common and frequent is heterosexual Anal Intercourse among south africans a systematic review and meta Analysis
    Journal of the International AIDS Society, 2017
    Co-Authors: Branwen N Owen, Jocelyn Elmes, Romain Silhol, Barbara Shacklett, Rebecca F. Baggaley, Ian Mcgowan, Que Dang, Edith Swann, Ariane Van Der Straten, Marieclaude Boily
    Abstract:

    Background : HIV is transmitted more effectively during Anal Intercourse (AI) than vaginal Intercourse (VI). However, patterns of heterosexual AI practice and its contribution to South Africa’s generalized epidemic remain unclear. We aimed to determine how common and frequent heterosexual AI is in South Africa. Methods : We searched for studies reporting the proportion practising heterosexual AI (prevalence) and/or the number of AI and unprotected AI (UAI) acts (frequency) in South Africa from 1990 to 2015. Stratified random-effects meta-Analysis by subgroups was used to produce pooled estimates and assess the influence of participant and study characteristics on AI prevalence. We also estimated the fraction of all sex acts which were AI or UAI and compared condom use during VI and AI. Results : Of 41 included studies, 31 reported on AI prevalence and 14 on frequency, over various recall periods. AI prevalence was high across different recall periods for sexually active general-risk populations (e.g. lifetime = 18.4% [95%CI:9.4–27.5%], three-month = 20.3% [6.1–34.7%]), but tended to be even higher in higher-risk populations such as STI patients and female sex workers (e.g. lifetime = 23.2% [0.0–47.4%], recall period not stated = 40.1% [36.2–44.0%]). Prevalence was higher in studies using more confidential interview methods. Among general and higher-risk populations, 1.2–40.0% and 0.7–21.0% of all unprotected sex acts were UAI, respectively. AI acts were as likely to be condom protected as vaginal acts. Discussion : Reported heterosexual AI is common but variable among South Africans. Nationally and regionally representative sexual behaviour studies that use standardized recall periods and confidential interview methods, to aid comparison across studies and minimize reporting bias, are needed. Such data could be used to estimate the extent to which AI contributes to South Africa’s HIV epidemic. Keywords : Anal Intercourse; heterosexual; sexual behaviour; South Africa (Published: 12 January 2017) To access the supplementary material to this article please see Supplementary Files under Article Tools online. Citation: Owen BN et al. Journal of the International AIDS Society 2017, 20:21162 http://www.jiasociety.org/index.php/jias/article/view/21162 | http://dx.doi.org/10.7448/IAS.20.1.21162

  • prevalence and frequency of heterosexual Anal Intercourse among young people a systematic review and meta Analysis
    Aids and Behavior, 2015
    Co-Authors: Branwen N Owen, Ailsa R. Butler, Rebecca F. Baggaley, Marieclaude Boily, Patrick M Brock, Michael Pickles, Marc Brisson
    Abstract:

    We aim to assess if heterosexual Anal Intercourse (AI) is commonly practiced and how frequently it is practiced by young people. We searched PubMed for articles published 1975 to July 2014 reporting data on the proportion of young people (mean age <25) practicing heterosexual AI (AI prevalence) and on number of AI acts (AI frequency). Stratified random-effects meta-Analysis and meta-regression were used to produce summary estimates and assess the influence of participant and study characteristics on AI prevalence. Eighty-three and thirteen of the 136 included articles reported data on lifetime AI prevalence and monthly AI frequency, respectively. Estimates were heterogenous. Overall summary estimates of lifetime AI prevalence were 22 % (95 % confidence interval 20–24) among sexually active young people, with no statistically significant differences by gender, continent or age. Prevalence increased significantly with confidentiality of interview method and, among males and in Europe, by survey year. Prevalence did not significantly differ by recall period. An estimated 3–24 % of all reported sex acts were AI. Reported heterosexual AI is common but variable among young people worldwide. To fully understand its impact on STI spread, more and better quality data on frequency of unprotected AI, and trends over time are required.

  • hiv transmission risk through Anal Intercourse systematic review meta Analysis and implications for hiv prevention
    International Journal of Epidemiology, 2010
    Co-Authors: Rebecca F. Baggaley, Richard G White, Marieclaude Boily
    Abstract:

    Background The human immunodeficiency virus (HIV) infectiousness of Anal Intercourse (AI) has not been systematically reviewed, despite its role driving HIV epidemics among men who have sex with men (MSM) and its potential contribution to heterosexual spread. We assessed the per-act and per-partner HIV transmission risk from AI exposure for heterosexuals and MSM and its implications for HIV prevention. Methods Systematic review and meta-Analysis of the literature on HIV-1 infectiousness through AI was conducted. PubMed was searched to September 2008. A binomial model explored the individual risk of HIV infection with and without highly active antiretroviral therapy (HAART). Results A total of 62 643 titles were searched; four publications reporting per-act and 12 reporting per-partner transmission estimates were included. Overall, random effects model summary estimates were 1.4% [95% confidence interval (CI) 0.2–2.5)] and 40.4% (95% CI 6.0–74.9) for per-act and per-partner unprotected receptive AI (URAI), respectively. There was no significant difference between per-act risks of URAI for heterosexuals and MSM. Per-partner unprotected insertive AI (UIAI) and combined URAI–UIAI risk were 21.7% (95% CI 0.2–43.3) and 39.9% (95% CI 22.5–57.4), respectively, with no available per-act estimates. Per-partner combined URAI–UIAI summary estimates, which adjusted for additional exposures other than AI with a ‘main’ partner [7.9% (95% CI 1.2–14.5)], were lower than crude (unadjusted) estimates [48.1% (95% CI 35.3–60.8)]. Our modelling demonstrated that it would require unreasonably low numbers of AI HIV exposures per partnership to reconcile the summary per-act and per-partner estimates, suggesting considerable variability in AI infectiousness between and within partnerships over time. AI may substantially increase HIV transmission risk even if the infected partner is receiving HAART; however, predictions are highly sensitive to infectiousness assumptions based on viral load. Conclusions Unprotected AI is a high-risk practice for HIV transmission, probably with substantial variation in infectiousness. The significant heterogeneity between infectiousness estimates means that pooled AI HIV transmission probabilities should be used with caution. Recent reported rises in AI among heterosexuals suggest a greater understanding of the role AI plays in heterosexual sex lives may be increasingly important for HIV prevention.