title: Condoms, Lubricants and Rectal Cleansing: Practices Associated with Heterosexual Penile-Anal Intercourse Amongst Participants in an HIV Prevention Trial in South Africa, Uganda and Zimbabwe.
abstract: We investigated condom and lubricant use, rectal cleansing and rectal gel use for penile-anal intercourse (PAI), during in-depth interviews with women from South Africa, Uganda and Zimbabwe who formerly participated in VOICE, a five-arm HIV prevention trial of two antiretroviral tablets and a vaginal gel. Few studies have addressed practices related to PAI among women; existing data from Africa on condom and lubricant use for PAI, as well as preparatory practices of PAI such as rectal cleansing, are limited to men who have sex with men. Women demonstrated a lack of awareness of HIV transmission risks of PAI and none of the participants reported using condom-compatible lubricants for PAI. Participants described a variety of preparatory rectal cleansing practices. Some participants disclosed rectal use of the vaginal study gel. Understanding practices related to PAI in Africa is critical to microbicide development, as these practices are likely to influence the acceptability, feasibility, and use of both vaginal and rectal microbicide products.
authors.affiliation: Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa. zoe.duby@gmail.com.|School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa. zoe.duby@gmail.com.|Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa. zoe.duby@gmail.com.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Duby
authors.affiliation: Women's Global Health Imperative, RTI International, San Francisco, CA, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Hartmann
authors.affiliation: Women's Global Health Imperative, RTI International, San Francisco, CA, USA.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Montgomery
authors.affiliation: School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Colvin
authors.affiliation: Population Council, New York, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mensch
authors.affiliation: Women's Global Health Imperative, RTI International, San Francisco, CA, USA.|University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Ariane
authors.initials: A
authors.lastname: van der Straten
mesh_terms: D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D001003:Anal Canal; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D020010:Heterosexuality / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D054327:Lubricants / Q000008:administration & dosage*; D008875:Middle Aged; D036301:Qualitative Research; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners; D013019:South Africa; D014454:Uganda; D047568:Unsafe Sex / Q000706:statistics & numerical data; D015030:Zimbabwe
chemical_list: D000891:Anti-Infective Agents, Local; D054327:Lubricants
keywords: Anal intercourse; Condom; HIV; Heterosexual; Lubricant; Rectal cleansing