The researchers set out to examine the prevalence and sources of coital bleeding among men and women living in a township in Cape Town. Genital bleeding during intercourse may play a part in facilitating the spread of HIV in South Africa, which has one of the world's fastest-growing HIV epidemics. In this study, a purposive sample of 464 men and 531 women completed anonymous street intercept surveys of HIV risk history and sexual behaviors.

Lifetime history of sexual intercourse that involved genital bleeding was reported by 31 percent of men and 26 percent of women. Recent coital bleeding (in the previous three months) was reported by 21 percent of men and 16 percent of women. More than 75 percent of coital bleeding was attributed to menses.

Across genders -- controlling for demographic, sexual behavior and life history factors -- recent coital bleeding was associating with being an indigenous African, having multiple sexual partners, and having higher rates of unprotected intercourse in the previous three months. Even after controlling for having had genital ulcers, people who reported coital bleeding were more than three times as likely to have been diagnosed with an STD.

Genital bleeding during intercourse may be common in South Africa, the researchers reported. "Prevention messages that promote condom use or refraining from sex when there is genital bleeding are therefore needed," the authors concluded.

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