Contribution of Anal Sex to HIV Prevalence Among Heterosexuals: A Modeling Analysis

O'Leary, Ann; DiNenno, Elizabeth; Honeycutt, Amanda; Allaire, Benjamin; Neuwahl, Simon; Hicks, Katherine; Sansom, Stephanie
October 2017
AIDS & Behavior;Oct2017, Vol. 21 Issue 10, p2895
Academic Journal
Anal intercourse is reported by many heterosexuals, and evidence suggests that its practice may be increasing. We estimated the proportion of the HIV burden attributable to anal sex in 2015 among heterosexual women and men in the United States. The HIV Optimization and Prevention Economics model was developed using parameter inputs from the literature for the sexually active U.S. population aged 13-64. The model uses differential equations to represent the progression of the population between compartments defined by HIV disease status and continuum-of-care stages from 2007 to 2015. For heterosexual women of all ages (who do not inject drugs), almost 28% of infections were associated with anal sex, whereas for women aged 18-34, nearly 40% of HIV infections were associated with anal sex. For heterosexual men, 20% of HIV infections were associated with insertive anal sex with women. Sensitivity analyses showed that varying any of 63 inputs by ±20% resulted in no more than a 13% change in the projected number of heterosexual infections in 2015, including those attributed to anal sex. Despite uncertainties in model inputs, a substantial portion of the HIV burden among heterosexuals appears to be attributable to anal sex. Providing information about the relative risk of anal sex compared with vaginal sex may help reduce HIV incidence in heterosexuals.


Related Articles

  • HIV Prevalence and Risk Behaviours from Three Consecutive Surveys Among Men Who Have Multiple Female Sexual Partners in Cape Town. Townsend, Loraine; Zembe, Yanga; Mathews, Catherine // AIDS & Behavior;Sep2013, Vol. 17 Issue 7, p2367 

    HIV bio-behavioural surveillance surveys conducted at regular intervals are critical for monitoring of, and informing a targeted response to the HIV pandemic. We used Respondent-driven Sampling in 2006, 2008 and 2010 to recruit men who have multiple female sexual partners. We performed several...

  • Increases in HIV Incidence Following Receptive Anal Intercourse Among Women: A Systematic Review and Meta-analysis. Stannah, James; Silhol, Romain; Elmes, Jocelyn; Owen, Branwen; Shacklett, Barbara L.; Anton, Peter; McGowan, Ian; van der Straten, Ariane; Dimitrov, Dobromir; Baggaley, Rebecca F.; Boily, Marie-Claude // AIDS & Behavior;Mar2020, Vol. 24 Issue 3, p667 

    Receptive anal intercourse (RAI) carries a greater per-act risk of HIV acquisition than receptive vaginal intercourse (RVI) and may influence HIV epidemics driven by heterosexual sex. This systematic review explores the association between RAI and incident HIV among women, globally. We searched...

  • Erratum to: Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic? Merli, M.; Moody, James; Mendelsohn, Joshua; Gauthier, Robin // Demography;Jun2015, Vol. 52 Issue 3, p943 

    A correction to the article on the compatibility of heterosexual contact patterns with an HIV/AIDS epidemic in the May 21, 2015 issue.

  • High Adherence to HIV Pre-exposure Prophylaxis and No HIV Seroconversions Despite High Levels of Risk Behaviour and STIs: The Australian Demonstration Study PrELUDE. Vaccher, Stefanie J.; Grulich, Andrew E.; Guy, Rebecca; Poynten, Isobel M.; Prestage, Garrett; Templeton, David; Zablotska, Iryna B.; Foster, Rosalind; Ryder, Nathan; Bloch, Mark; Carr, Andrew; McNulty, Anna; Ooi, Catriona; Pell, Catherine // AIDS & Behavior;Jul2019, Vol. 23 Issue 7, p1780 

    PrELUDE study evaluated daily pre-exposure prophylaxis (PrEP) in high-risk individuals in Australia. This open-label, single-arm study tested participants for HIV/STI and collected behavioural information three-monthly. We report trends over 18 months in medication adherence, side-effects,...

  • HIV Among Injection Drug Users and Their Intimate Partners in Almaty, Kazakhstan. El-Bassel, Nabila; Gilbert, Louisa; Terlikbayeva, Assel; Wu, Elwin; Beyrer, Chris; Shaw, Stacey; Hunt, Tim; Ma, Xin; Chang, Mingway; Ismayilova, Leyla; Tukeyev, Marat; Zhussupov, Baurzhan; Rozental, Yelena // AIDS & Behavior;Sep2013, Vol. 17 Issue 7, p2490 

    This paper examines prevalence rates of HIV, HCV, and syphilis among a sample of injecting drug users (IDUs) and their heterosexual intimate partners ( N = 728) from Almaty, Kazakhstan. The study uses baseline data from Project Renaissance, a couple-based HIV prevention intervention delivered to...

  • The HIV epidemic in Greenland - a slow spreading infection among adult heterosexual Greenlanders. Bjorn-Mortensen, Karen; Ladefoged, Karin; Obel, Niels; Helleberg, Marie // International Journal of Circumpolar Health;2013, Vol. 72, p1 

    Introduction. We aimed to characterise the HIV epidemic in Greenland and to determine incidence, prevalence, mortality rates (MR) and specific causes of deaths. Study design. The study design used was population-based nationwide cohort study. Methods. We included all patients diagnosed with HIV...

  • Partnership Concurrency and Coital Frequency. Gaydosh, Lauren; Reniers, Georges; Helleringer, Stéphane // AIDS & Behavior;Sep2013, Vol. 17 Issue 7, p2376 

    National HIV prevalence estimates across sub-Saharan Africa range from less than 1 percent to over 25 percent. Recent research proposes several explanations for the observed variation, including prevalence of male circumcision, levels of condom use, presence of other sexually transmitted...

  • Identifying and Characterizing Places for the Targeted Control of Heterosexual HIV Transmission in Urban Areas. Polk, Sarah; Ellen, Jonathan; Fichtenberg, Caroline; Huettner, Steven; Reilly, Meredith; Parekh, Jenita; Jennings, Jacky // AIDS & Behavior;Aug2014, Vol. 18 Issue 8, p1476 

    Places with active HIV transmission may serve as key locations for targeted control. In 2008-2009, heterosexual sex partner venues in Baltimore, MD were identified using a three-phase process and characterized by the presence or absence of HIV cases. 1,594 participants aged 18-35 years were...

  • High Prevalence of Signs of Renal Damage Despite Normal Renal Function in a Cohort of HIV-Infected Patients: Evaluation of Associated Factors. Bonjoch, Anna; Juega, Javier; Puig, Jordi; Pérez-Alvarez, Nuria; Aiestarán, Aintzane; Echeverría, Patricia; Pérez, Vanessa; Clotet, Bonaventura; Romero, Ramon; Bonet, Josep; Negredo, Eugenia // AIDS Patient Care & STDs;Oct2014, Vol. 28 Issue 10, p524 

    Renal disorders are an emerging problem in HIV-infected patients. We performed a cross-sectional study of the first 1000 HIV-infected patients attended at our HIV unit who agreed to participate. We determined the frequency of renal alterations and its related risk factors. Summary statistics and...

  • Risk Factors for HIV Acquisition in High Risk Women in a Generalised Epidemic Setting. Naicker, Nivashnee; Kharsany, Ayesha; Werner, Lise; Loggerenberg, Francois; Mlisana, Koleka; Garrett, Nigel; Abdool Karim, Salim // AIDS & Behavior;Jul2015, Vol. 19 Issue 7, p1305 

    In South Africa young women bear a disproportionate burden of HIV infection however, risk factors for HIV acquisition are not fully understood in this setting. In a cohort of 245 women, we used proportional hazard regression analysis to examine the association of demographic, clinical and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics