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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

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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.

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Acknowledgments

We would like to acknowledge the women who participated in this study. The full MTN-003D study team can be viewed at http://www.mtnstopshiv.org/studies/4493. The study was designed and implemented by the Microbicide Trials Network (MTN). The MTN is funded by the National Institute of Allergy and Infectious Diseases (UM1AI068633, UM1AI068615, UM1AI106707), with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the U.S. National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa

    Zoe Duby

  2. School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa

    Zoe Duby & Christopher J. Colvin

  3. Women’s Global Health Imperative, RTI International, San Francisco, CA, USA

    Miriam Hartmann, Elizabeth T. Montgomery & Ariane van der Straten

  4. Population Council, New York, USA

    Barbara Mensch

  5. University of California, San Francisco, San Francisco, CA, USA

    Ariane van der Straten

  6. Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa

    Zoe Duby

Authors
  1. Zoe Duby
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  2. Miriam Hartmann
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  3. Elizabeth T. Montgomery
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  4. Christopher J. Colvin
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  5. Barbara Mensch
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  6. Ariane van der Straten
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Correspondence to Zoe Duby.

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Duby, Z., Hartmann, M., Montgomery, E.T. et al. 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. AIDS Behav 20, 754–762 (2016). https://doi.org/10.1007/s10461-015-1120-0

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  • DOI: https://doi.org/10.1007/s10461-015-1120-0

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