High-Risk Sexual Behavior in Men Attending a Sexually Transmitted Infection Clinic in Durban, South Africa
December 13, 2007
At the outset of the local HIV epidemic in 1988-89, a study of Durban men with genital ulcer disease (GUD) found that 36 percent continued with sexual intercourse despite having symptoms. The authors undertook the present study to determine whether such high-risk behavior remained prevalent, and to enquire about similar risk behaviors with other STD-related problems.
The study participants were 650 men with a new complaint at the main Durban STD clinic. Researchers administered a standard questionnaire. Polymerase chain reaction (PCR) tests were performed to diagnose genital herpes from ulcer specimens and gonorrhea and chlamydia from those with urethral discharge and/or dysuria. In addition, serology tests were performed for HIV, herpes simplex virus type 2 (HSV-2), and syphilis.
Between 33.3 percent and 43.9 percent of the men with GUD, herpetic ulcers, gonorrhea, and/or chlamydia or dysuria reported having had sex since the onset of symptoms. Despite symptoms, incidence of condom use in all groups was extremely low. Of the 87 men with genital ulcers who tested positive for genital herpes, 30 (34.4 percent) reported having sex since the beginning of symptoms, of whom 28 (93.3 percent) reported unprotected sex.
The researchers confirmed a high level of risk behavior in the men for whom genital herpes was the most common cause of GUD. "This risky sexual behavior could reflect disinhibition, possibly because so many have already been infected with HSV-2, lack of education or other unknown factors. Syndromic STI management should be strengthened with intensive health education to promote community awareness of both genital ulceration and genital herpes and their role in facilitating HIV transmission," the authors concluded. "The low level of condom use indicates that condom promotion campaigns still have much to achieve."
Sexually Transmitted Infections
12.01.2007; Vol. 83; No. 7: P. 530-533; N. O'Farrell; L. Morison; P. Moodley; K. Pillay; T. Vanmali; M. Quigley; A.W. Sturm
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.