Vaginal sex, thigh sex, even armpit sex – people have sex in lots of ways, but in heterosexual anal sex, HIV prevention programming is silent about the high risk of infection that goes with it, and people may have mistaken this silence for safety.
The risk of contracting HIV through unprotected receptive anal sex is almost 20 times greater than the HIV risk associated with vaginal intercourse.
While this fact is often a focus in HIV prevention programming aimed at men-who-have-sex-with-men (MSM), it has been largely left out of programmes for heterosexuals, according to Zoe Duby of the University of Cape Town, South Africa, and the Desmond Tutu HIV Foundation.
Duby presented the findings of her study, which interviewed almost 400 people in Tanzania, Uganda and Kenya, at the 1st HIV Social Sciences and Humanities Conference held recently in Durban, South Africa.
“Safer sex programming has, in my opinion, failed to take into account varying definitions of sex. The omission of anal sex in safe sex messaging has been interpreted as meaning that anal sex is safe,” she told IRIN/PlusNews.
“What people preach out there, it’s just vaginal sex – not information on anal [sex],” said a young woman from Salgaa, Kenya, who was quoted in the research. “So somebody thinks, ‘if I do [sex] this other way, then I will not get HIV.’”
Even more worrying was that research showed healthcare workers often held similar views, and some incorrectly believed HIV was only present in vaginal fluid. The virus is, in fact, also present in male sperm and blood.
“Me, I do not want to practice vaginal sex because that is the highest [risk] sex that transmits HIV, so it is a belief… that non-vaginal sex does not transmit HIV,” one Kenyan healthcare worker reported.
A nurse in Malaba, Uganda, said: “As you go and have sex vaginally you can get HIV, but these other methods, they do not expose you [to HIV].”
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