BACKGROUND: Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. METHODS: HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. RESULTS: Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. CONCLUSIONS: High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.
BACKGROUND: Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. METHODS:HIV-uninfectedwomen presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. RESULTS: Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. CONCLUSIONS: High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.
Authors: Frances H Priddy; Sabina Wakasiaka; Tina D Hoang; Donna J Smith; Bashir Farah; Carlos del Rio; Jeckoniah Ndinya-Achola Journal: AIDS Res Hum Retroviruses Date: 2011-05-06 Impact factor: 2.205
Authors: Fiona Scorgie; Busisiwe Kunene; Jennifer A Smit; Ntsiki Manzini; Matthew F Chersich; Eleanor M Preston-Whyte Journal: Cult Health Sex Date: 2009-04
Authors: Landon Myer; Lynette Denny; Michelle De Souza; Mark A Barone; Thomas C Wright; Louise Kuhn Journal: Sex Transm Dis Date: 2004-03 Impact factor: 2.830
Authors: Janneke H H M van de Wijgert; Charles S Morrison; Peter G A Cornelisse; Marshall Munjoma; Jeanne Moncada; Peter Awio; Jing Wang; Barbara Van der Pol; Tsungai Chipato; Robert A Salata; Nancy S Padian Journal: J Acquir Immune Defic Syndr Date: 2008-06-01 Impact factor: 3.731
Authors: Jillian Pintye; Dvora L Joseph Davey; Anjuli D Wagner; Grace John-Stewart; Rachel Baggaley; Linda-Gail Bekker; Connie Celum; Benjamin H Chi; Thomas J Coates; Allison K Groves; Jessica E Haberer; Renee Heffron; John Kinuthia; Lynn T Matthews; James A McIntyre; Dhayendre Moodley; Lynne M Mofenson; Nelly Mugo; Andrew Mujugira; Landon Myer; Steven Shoptaw; Lynda Stranix-Chibanda; Jared M Baeten Journal: Lancet HIV Date: 2020-08 Impact factor: 12.767
Authors: Jillian Pintye; John Kinuthia; D Allen Roberts; Anjuli D Wagner; Kenneth Mugwanya; Felix Abuna; Harison Lagat; George Owiti; Carol E Levin; Ruanne V Barnabas; Jared M Baeten; Grace John-Stewart Journal: J Acquir Immune Defic Syndr Date: 2018-12-15 Impact factor: 3.731
Authors: Jayalakshmi Ravindran; Barbra A Richardson; John Kinuthia; Jennifer A Unger; Alison L Drake; Lusi Osborn; Daniel Matemo; Janna Patterson; R Scott McClelland; Grace John-Stewart Journal: J Infect Dis Date: 2021-12-15 Impact factor: 5.226
Authors: Michelle C Sabo; Dara A Lehman; Jillian C Pintye; Bingjie Wang; Alison L Drake; John Kinuthia; Lusi Osborn; Daniel Matemo; Barbra A Richardson; Julie Overbaugh; Grace John-Stewart; Susan M Graham Journal: AIDS Date: 2020-10-01 Impact factor: 4.632
Authors: McKenna C Eastment; John Kinuthia; Lei Wang; George Wanje; Katherine Wilson; Anne Kaggiah; Jane M Simoni; Kishorchandra Mandaliya; Danielle N Poole; Barbra A Richardson; Walter Jaoko; Grace John-Stewart; R Scott McClelland Journal: PLoS One Date: 2021-07-19 Impact factor: 3.240