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2014 ; 67
(4
): 424-9
Nephropedia Template TP
gab.com Text
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English Wikipedia
Order of orifices: sequence of condom use and ejaculation by orifice during anal
intercourse among women: implications for HIV transmission
#MMPMID25356778
Gorbach PM
; Pines H
; Javanbakht M
; Weiss RE
; Jeffries R
; Cranston RD
; Fuchs EJ
; Hezerah M
; Brown S
; Voskanian A
; Anton P
J Acquir Immune Defic Syndr
2014[Dec]; 67
(4
): 424-9
PMID25356778
show ga
BACKGROUND: 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. 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. RESULTS: 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, <10% 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. CONCLUSIONS: 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.