Sex during genital bleeding and risks for HIV infection: preliminary study of sexually transmitted infection clinic patients in Cape Town, South Africa.

Practicing sexual intercourse in the presence of blood is a potentially important factor in facilitating HIV transmission. In the current study 149 men and 78 women receiving diagnostic and treatment services for repeated sexually transmitted infections (STI) in Cape Town, South Africa, provided behavioural data on sexual exposure to blood. Results showed that 46% of women and 12% of men reported lifetime prevalence of engaging in sexual intercourse while their genitals were bleeding and 7% of women and 40% of men reported sexual intercourse with a partner whose genitals were bleeding; 27% of men and 22% of women had engaged in sexual intercourse with blood present within the previous month. Individuals who had engaged in sexual intercourse involving blood had significantly greater numbers of sex partners in the previous month, engaged in higher rates of unprotected vaginal intercourse and total anal intercourse occasions during that time period. Engaging in sex during genital bleeding was also related to greater lifetime prevalence of sexually transmitted infections and unexplained genital discharge. These findings add to the growing evidence that exposure to blood during vaginal intercourse may be prevalent and may be an important contributing factor to the rapid spread of HIV in Southern Africa.