Sexual behaviour of women in rural South Africa: a descriptive study

Investigating causes of the high prevalence of sexually transmitted infections in Du Noon

BACKGROUND

 In South Africa, sexually transmitted infections (STIs) represent a significant public health issue. Sexually transmitted infections contribute significantly to the burden of disease in South Africa and are recognised as one of the main causes of the human immunodeficiency virus (HIV) epidemic. The aim of this study was to investigate the potential causes of the high prevalence of STIs in the Du Noon population.

METHODS

 A mixed methodology study involving 40 participants between the ages of 18 years and 45 years was conducted at Du Noon community health centre from 01 May 2021 to 15 May 2021. Both structured questionnaires and one-on-one patient interviews with open-ended questions were utilised to collect data.

RESULTS

 Cultural beliefs, having multiple partners, a lack of partner notification, alcohol consumption, and a lack of condom usage were found to be the main contributing factors to the high incidence of STIs. Sex education appears to be lacking. Our findings reflected the other well-known cultural and socioeconomic issues confronting South African communities, for example, poverty, age-disparate relationships, and polygamous relationships.

CONCLUSION

 The cultural perspectives and understandings of sexual interactions of older men appear to have an impact on younger generations; as do peer pressure, social media and other socio-economic factors. There is an urgent need to shift cultural ideologies and norms among the youth. More research is needed to understand the views and misconceptions of the general public about STIs.Contribution: This study highlighted how health education challenges, interpersonal relationships, and socioeconomic barriers are still important factors in STI transmission.

Epidemiology and Burden of Human Papillomavirus and Related Diseases, Molecular Pathogenesis, and Vaccine Evaluation

Diagnosed in more than 90% of cervical cancers, the fourth deadliest cancer in women, human papillomavirus (HPV) is currently the most common pathogen responsible for female cancers. Moreover, HPV infection is associated with many other diseases, including cutaneous and anogenital warts, and genital and upper aerodigestive tract cancers. The incidence and prevalence of these pathologies vary considerably depending on factors including HPV genotype, regional conditions, the study population, and the anatomical site sampled. Recently, features of the cervicovaginal microbiota are found to be associated with the incidence of HPV-related diseases, presenting a novel approach to identify high-risk women through both blood and cervical samples. Overall, the HPV repartition data show that HPV infection and related diseases are more prevalent in developing countries. Moreover, the available (2-, 4-, and 9-valent) vaccines based on virus-like particles, despite their proven effectiveness and safety, present some limitations in terms of system development cost, transport cold chain, and oncogenic HPV variants. In addition, vaccination programs face some challenges, leading to a considerable burden of HPV infection and related diseases. Therefore, even though the new (9-valent) vaccine seems promising, next-generation vaccines as well as awareness programs associated with HPV vaccination and budget reinforcements for immunization are needed.

Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review

BACKGROUND

Oral and anal sexual behaviours are increasingly reported among adolescents and adults reporting heterosexual sex in peer-reviewed journals in high income countries, but less is known about these behaviours in low and middle-income countries, especially in sub-Saharan Africa. The aim of this systematic review is to describe the prevalence of, and motivations for, oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa.

METHODS

A systematic review of published articles that reported oral and or anal sex in sub-Saharan Africa was conducted from seven databases up to and including 30th August 2018.

RESULTS

Of 13,592 articles, 103 met the inclusion criteria. The prevalence of reporting ever practising oral sex among adolescents, university students and a combined population of adolescents/adults ranged from 1.7-26.6%, 5.0-46.4% and 3.0-47.2% respectively. Similarly, prevalences of reported ever practising anal sex ranged from 6.4-12.4% among adolescents, 0.3-46.5% among university students and 4.3-37.8% amongst combined population of adolescents and adults. Higher prevalences of oral and anal sex were reported among populations at high-risk for sexually transmitted infections and HIV and university students and, in most studies, both behaviours were more commonly reported by males than females. Heterosexual oral and anal sexual acts were associated with some high-risk behaviours such as inconsistent condom use and multiple sexual partners.

CONCLUSION

Reported oral and anal sex between men and women are prevalent behaviours in sub-Saharan Africa. Health professionals and policy makers should be aware of these behaviours and their potential associated health risks.