Table 2 Factors reported to be associated with engaging in heterosexual oral and anal sex among adolescents and adults in sub-Saharan Africa
Author; Year; Country | Study population (no of individuals) | Test of association | Reported associated risk factor for Oral sex | Summary of results |
 Gathece et al. 2000; Kenya [133] | FSW (322) | Unadjusted, Chi Square | Age | Older respondents were more likely to engage in oral sex (X2 = 18.847, p = 0.002) |
 Kazaura et al. 2009; Tanzania [48] | Adolescents in schools/community (885) | Unadjusted, Chi Square | gender | Male vs female (9.4% vs 5.8% p = 0.07) |
 Chege et al. 2012; Kenya [51] | Adult men and women in community (846) | Unadjusted, Chi Square | gender | Male vs female (29% vs 21%, p = 0.03) |
 Gevers et al. 2013; South Africa [54] | Adolescents in schools/community (474) | Unadjusted, Chi Square and Fisher’s Exact Test | type of sexual relationship by gender | For Girls In the past 3 months: currently dating vs not currently dating (6.5% vs 0%; p < 0.01) Ever practiced: currently dating vs not currently dating (8.1% vs 0.6%; p < 0.01) For Boys In the past 3 months: currently dating vs not currently dating (7.8% vs 2.0%; p < 0.06 Ever practiced: currently dating vs not currently dating (20.2% vs 8.1%; p = 0.01) |
 Folayan et al. 2014; Nigeria [56] | Adolescents in schools/community (357) | Unadjusted, Chi Square | gender | female vs male (23.5% vs 15.1%, p = 0.01) |
 Ambaw et al. 2010; Ethiopia [66] | University students (1945) | Adjusted, Logistic regression | Gender; level of education; faculty; place of residence; marital status | Male (AOR = 1.6, 95%CI1.02–2.57); protestant (AOR = 0.59, 95%CI 0.39–0.9); year one student (AOR = 2.14, 95%CI1.23–3.66); business and economics faculty (AOR = 5.47, 95%CI3.09–9.67), technology faculty (AOR = 6.23, 95%CI3.32–11.67), humanities faculty (AOR = 3.15, 95%CI1.92–5.18), social sciences faculty (AOR = 2.96, 95%CI1.61–5.42) and education faculty (AOR = 3.91, 95%CI2.01–7.61); out of campus (AOR = 1.85, 95%CI1.09–3.14); have boy/girlfriend (AOR = 1.81, 95%CI1.17–2.8) |
 Cherie et al. 2012; Ethiopia [52] | Adolescents in schools/community (3543) | Adjusted, Logistic regression | age; gender; attitude to oral sex; aspiration for college education; self-esteem; maternal education; partner education; perception of peer oral sexual activity and living arrangement | Younger age (AOR = 3.2, 95%CI 1.9–5.3); female (AOR = 1.3, 95%CI 1.1–2.2); positive attitude to oral sex (AOR = 2.3, 95%CI 1.7–4.5); low aspiration to attend college education (AOR = 3.1, 95%CI = 2.8–5.9); low self-esteem (AOR = 2.1, 95%CI 1.7–3.9); illiterate mother (AOR = 11.5, 95%CI 6.4–18.5); illiterate father (AOR = 1.4, 95%CI 0.9–3.2); friends that engage in oral sex (AOR = 5.7, 95%CI 3.6–11.2); living with both parents (AOR = 0.4, 95%CI 0.2–0.9) |
 Kerwin et al. 2014; Malawi [131] | Adult men in community (2753) | Adjusted, Logistic regression | no of lifetime sex partners; ever used condom for oral sex; history of spending in the past 3 months | higher total lifetime sex partner (AOR = 1.04, 95%CI 1.02–1.06); ever used condom (AOR = 3.16, 95%CI 1.47–6.8); history of spending in the last 3 months (AOR = 1.94, 95%CI 1.55–2.42) |
Author; Year; Country | Study population (no of individuals) | Test of association | Reported associated risk factor for Anal sex | Summary of results |
 Chege et al. 2012; Kenya [51] | Adult men and women in community (846) | Unadjusted, Chi Square | Gender | female vs male (25% vs 16%, p = 0.03) |
 Gevers et al. 2013; South Africa [54] | Adolescents in schools/community (474) | Unadjusted, Chi Square and Fisher’s Exact Test | type of sexual relationship by gender | For Girls In the past 3 months: currently dating vs not currently dating (2.4% vs 0%, p = 0.09) Ever practiced: currently dating vs not currently dating (3.3% vs 0%, p = 0.04) For Boys In the past 3 months: currently dating vs not currently dating (13.3% vs 2.0%, p < 0.01) Ever practiced: currently dating vs not currently dating (15.6% vs 6.0%, p = 0.01) |
 Priddy 2011; Kenya [89] | FSW (200) | Unadjusted, Chi Square | type of sexual relationship | regular vs casual vs primary (35% vs 29% vs 9%, p < 0.01) |
 Kalichman et al. 2009; South Africa [84] | Adult men and women in community /clinic (M = 2593; F = 1818) | Adjusted, Logistic regression | age; sexual relationship; history of condom use; history of STI; transactional sex; alcohol and cannabis abuse use in past 3 months; HIV test and status; number of sexual partners | Older age (AOR = 0.97, 95%CI 0.96–0.98); married/living with partner (AOR = 0.62, 0.5–0.77); never used condom (AOR = 1.79, 1.49–2.17); history of STI (AOR = 1.64, 1.46–1.85); received gift for sex (AOR = 1.77, 1.57–1.99); given gift for sex (AOR = 1.7, 1.51–1.9); alcohol use in past 3 months (AOR = 2.16, 1.77–2.63); cannabis use in past 3 months (AOR = 1.97, 1.62–2.4); had HIV test (AOR = 1.44, 1.19–1.73); test HIV positive (AOR = 2.62, 1.89–3.63); increased number of sexual partners (AOR = 1.26, 1.2–1.32); unprotected vaginal intercourse (AOR = 0.97, 0.94–0.98); previous vaginal intercourse with condom (AOR = 1.04, 1.03–1.05); increasing percentage condom use during vaginal intercourse (AOR = 5.61, 4.27–7.37) |
 Ambaw et al. 2010; Ethiopia [66] | University students (1921) | Adjusted, Logistic regression | Faculty; marital status | Business and economics faculty (AOR = 6.3, 95%CI2.64–15.05), technology faculty (AOR = 7.5, 95%CI2.96–18.99), humanities faculty (AOR = 4.59, 95%CI2.19–10.05), social sciences law faculty (AOR = 3.02, 95%CI1.15–7.94) and education faculty (AOR = 5.85, 95%CI2.26–15.1); ever married (AOR = 4.06, 95%CI1.53–10.79) |
 Veldhuijzen et al. 2011; Rwanda and Kenya [90] | FSW Kigal = 800; Momb = 820 | Adjusted, Logistic regression | inconsistent condom use; number of sexual partner; alcohol use before sex; year of sex work and history of genital symptoms | For the Kigali cohorts - inconsistent condom use with casual partner (AOR = 5.9, 95%CI 1.4–24.7); had more than 5 sexual partners in last week (AOR = 4.34, 95%CI 1.52–12.36); regular use of alcohol before sex (AOR = 2.83, 95%CI 1.37–5.84). For Mombasa cohorts - more than 5 years of sex work (AOR = 2.44, 95%CI 1.22–4.89); inconsistent condom use with casual partner or client (AOR = 2.1, 95%CI 1.10–4.20); condom not used in the last sex (AOR = 3.40, 95%CI 1.70–6.80); had more than 5 sexual partners in last week (AOR = 2.20, 95%CI 1.10–4.30); had genital symptoms (AOR = 3.60, 95%CI 1.70–7.90). |
 Kalichman et al. 2011; South Africa [87] | Men and women attending bar/night clubs (4965) | Adjusted, Logistic regression | age; education; type of sexual relationship; meeting sexual partner in Shebeen in past months | Age (AOR = 0.97, 95%CI 0.96–0.98); primary sexual partner (AOR = 1.56, 1.19–2.05); casual sexual partner (AOR = 2.33, 1.92–2.83); meeting sexual partner in Shebeen (drinking spot) in the past month (AOR = 1.81, 95%CI 1.47–2.22) |
 Cherie et al. 2012; Ethiopia [52] | Adolescents in schools/community (3543) | Adjusted, Logistic regression | age; gender; attitude to oral sex; aspiration for college education; self-esteem; maternal education; partner education; perception of peer oral/anal sexual activity and living arrangement | Younger age (AOR = 1.7, 95%CI 1.3–3.1), female (AOR = 2.9, 1.6–4.7), having positive attitude towards anal sex (AOR = 6.2, 95%CI 3.8–12.4), having low aspiration for college education (AOR = 4.2, 95%CI 2.8–8.1), having low self-esteem (AOR = 1.6, 95%CI 1.2–3.1); illiterate mother (AOR = 11.6, 95%CI 7.8–19.6); illiterate father (AOR = 7.8, 95%CI 5.3–14.9); friends that engage in oral/anal sex (AOR = 9.7, 95%CI 5.4–17.7); living with both parents (AOR = 0.4, 95%CI 0.2–0.9) |