{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:24:29Z","timestamp":1771064669421,"version":"3.50.1"},"reference-count":11,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":5217,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,5,18]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Epidemiological and HIV prevention studies in sub-Saharan Africa have almost exclusively focussed on vaginal transmission of HIV, the primary mode of transmission in the region. Little is known about the prevalence of heterosexual anal intercourse (AI), its correlates and its role in the spread of HIV. Prevention messaging seldom, if ever, includes AI. Methods: Sexual and other risk behaviours (including frequency of AI) were assessed in two cross-sectional surveys of female sex workers (FSW) in Kigali, Rwanda (n = 800) and Mombasa, Kenya (n = 820). In addition, a subset of FSW surveyed in Kigali attended seven focus group discussions and four in-depth interviews. Results: AI was reported by 5.5% and 4.3% of FSW in the cross-sectional surveys, in Kigali and Mombasa, respectively. FSW practising AI reported multiple risk factors for HIV transmission: inconsistent condom use (odds ratio (OR) Kigali 5.9 (95% CI 1.4\u201324.7); OR Mombasa 2.1 (1.1\u20134.2)); more than five sexual partners in the past week (OR Kigali 4.3 (1.5\u201312.4); OR Mombasa 2.2 (1.1\u20134.3)); alcohol use before sex (OR Kigali 2.8 (1.4\u20135.8)); more than 5 years of female sex work (OR Mombasa 2.4 (1.2\u20134.9)); and history of genital symptoms in the past year (OR Mombasa 3.6 (1.7\u20137.9)). AI was, however, not associated with HIV prevalence (OR Kigali 0.9 (0.5\u20131.9); OR Mombasa 0.5 (0.2\u20131.2)). Negative connotations and stigma associated with AI were expressed during qualitative interviews. Conclusions: AI was associated with several indicators of sexual risk behaviour. Prevalence of AI was probably underreported due to social desirability bias. Stigma associated with AI poses methodological challenges in obtaining valid data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh10047","type":"journal-article","created":{"date-parts":[[2011,6,22]],"date-time":"2011-06-22T03:49:14Z","timestamp":1308714554000},"page":"251-254","source":"Crossref","is-referenced-by-count":23,"title":["Anal intercourse among female sex workers in East Africa is associated with other high-risk behaviours for HIV"],"prefix":"10.1071","volume":"8","author":[{"given":"Nienke J.","family":"Veldhuijzen","sequence":"first","affiliation":[{"name":"AAcademic Medical Center of the University of Amsterdam and Amsterdam Institute for Global Health and Development, PO Box 22700, 1100 DE Amsterdam, The Netherlands."},{"name":"GCorresponding author. Email: n.veldhuijzen@amc-cpcd.org"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Ingabire","sequence":"additional","affiliation":[{"name":"BProject Ubuzima, Rue Akagera 716, PO Box 4560, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Luchters","sequence":"additional","affiliation":[{"name":"CInternational Centre for Reproductive Health, Tudor Mboya Avenue, PO Box 91109, Mombasa, Kenya."},{"name":"DInternational Centre for Reproductive Health, Department of Uro-gynaecology, Ghent University, De Pintelaan 185-P3, 9000 Ghent, Belgium."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilkister","family":"Bosire","sequence":"additional","affiliation":[{"name":"CInternational Centre for Reproductive Health, Tudor Mboya Avenue, PO Box 91109, Mombasa, Kenya."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Braunstein","sequence":"additional","affiliation":[{"name":"EDepartment of Epidemiology Columbia University, 722\u2009W. 168th Street, New York, NY 10032, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Chersich","sequence":"additional","affiliation":[{"name":"DInternational Centre for Reproductive Health, Department of Uro-gynaecology, Ghent University, De Pintelaan 185-P3, 9000 Ghent, Belgium."},{"name":"FCentre for Health Policy, School of Public Health, University of Witwatersrand, Private Bag 3, Wits 2050, South Africa."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janneke","family":"van de Wijgert","sequence":"additional","affiliation":[{"name":"AAcademic Medical Center of the University of Amsterdam and Amsterdam Institute for Global Health and Development, PO Box 22700, 1100 DE Amsterdam, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2011,5,18]]},"reference":[{"key":"2025102616582605500_R1","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/S0140-6736(00)04331-2","article-title":"Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1 discordant couples in Rakai, Uganda.","volume":"357","author":"Gray","year":"2001","journal-title":"Lancet"},{"key":"2025102616582605500_R2","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/S1473-3099(08)70156-7","article-title":"Rethinking the heterosexual infectivity of HIV-1: a systematic review and meta-analysis.","volume":"8","author":"Powers","year":"2008","journal-title":"Lancet"},{"key":"2025102616582605500_R3","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1093\/ije\/dyq057","article-title":"HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention.","volume":"39","author":"Baggaley","year":"2010","journal-title":"Int J Epidemiol"},{"key":"2025102616582605500_R4","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1097\/01.aids.0000198083.55078.02","article-title":"Heterosexual anal intercourse increases risk of HIV infection among young South African men.","volume":"20","author":"Lane","year":"2006","journal-title":"AIDS"},{"key":"2025102616582605500_R5","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1136\/sti.2008.035287","article-title":"Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa.","volume":"85","author":"Kalichman","year":"2009","journal-title":"Sex Transm Infect"},{"key":"2025102616582605500_R6","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1136\/sti.2007.028852","article-title":"Screening for genital and anorectal sexually transmitted infections in HIV prevention trials in Africa.","volume":"84","author":"Grijsen","year":"2008","journal-title":"Sex Transm Infect"},{"key":"2025102616582605500_R7","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1136\/sti.2006.019794","article-title":"Anal and dry sex in commercial sex work, and relation to risk for sexually transmitted infections and HIV in Meru, Kenya.","volume":"82","author":"Schwandt","year":"2006","journal-title":"Sex Transm Infect"},{"key":"2025102616582605500_R8","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.jclinepi.2008.07.011","article-title":"Many vaginal microbicide trial participants acknowledged they had misreported sensitive sexual behavior in face-to-face interviews.","volume":"62","author":"Turner","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"2025102616582605500_R9","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1080\/09540120701408134","article-title":"Sexual coercion and sexual desire: ambivalent meanings of heterosexual anal sex in Soweto, South Africa.","volume":"19","author":"Stadler","year":"2007","journal-title":"AIDS Care"},{"key":"2025102616582605500_R10","unstructured":"Measure DHS. HIV\/AIDS Datacomplier. Program areas and indicators. Calverton: DHS; 2010. Available online at: www.measuredhs.com\/hivdata\/ind_tbl.cfm [Verified 25 August 2010]."},{"key":"2025102616582605500_R11"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/8\/2\/251\/1253472\/sh10047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/8\/2\/251\/1253472\/sh10047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T20:58:32Z","timestamp":1761512312000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/8\/2\/251\/184668\/Anal-intercourse-among-female-sex-workers-in-East"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,5,18]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,5,18]]}},"URL":"https:\/\/doi.org\/10.1071\/sh10047","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5,18]]}}}