The Prevalence and Correlates of Oral Sex in Malawi

The latest paper from our ongoing project on the potential of oral sex as a safer sex strategy in sub-Saharan African has been accepted for publication at the International Journal of Sexual Health. This paper, which I coauthored with Sallie Foley of the University of Michigan Graduate School of Social Work and my advisor (and study PI), economics Professor Rebecca Thornton, measures the how common oral sex is in Malawi and what factors are associated with it. Here’s the abstract:

Despite medical evidence that female-to-male oral sex (fellatio) carries a lower risk of HIV transmission than unprotected vaginal intercourse, little research exists on the practice of fellatio in Africa. We use two samples of men from Malawi, one rural and one urban, to examine the prevalence of oral sex. While 97 percent of the rural sample and 87 percent of the urban sample report having had vaginal sex, just 2 percent and 12 percent respectively say they had ever received oral sex. Only half of the rural sample, and less than three quarters of the urban sample, report having heard of oral sex. Education, exposure to newspapers and television, and condom use significantly predict oral sex knowledge after controlling for other confounding factors, while exposure to radio does not. The large gap between sexual activity and oral sex prevalence suggests that fellatio should be taken into consideration as a potential component of a HIV-prevention strategy, but further quantitative and qualitative research that includes women as well as men is needed to understand its potential benefits and drawbacks.

A copy of the final manuscript, not yet typeset, is available here. The full citation is: Kerwin, J. T., Thornton, R. L., & Foley, S. M. (in press). Prevalence of and Factors Associated with Oral Sex among Rural and Urban Malawian Men. International Journal of Sexual Health. doi:10.1080/19317611.2013.830671

We got accepted just before I left for my latest trip to Malawi (for another project), and turned in the proofs just as the fall semester was starting here at Michigan, so putting up a link to the article fell way down my to-do list. Today they sent me an email reminding me that not only is the manuscript already online, but that I also have a limited-use public link to it that people can use to access the PDF if they can’t get through the Taylor and Francis paywall. Contact me here or through my umich email address if you want the link.

The previous paper to come out of this project was called “Missing Safer Sex Strategies in HIV Prevention: A Call for Further Research”, and was published in African Population Studies. Our next step will likely be to exploit some novel data we have collected on people’s attitudes towards oral sex and sexual activity in general, which fills some of the gaps left by the just-accepted article. In particular, it includes women instead of just men, and has a qualitative component (we did a set of gender-segregated focus groups).

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