Send to

Choose Destination
PLoS One. 2019 Jan 16;14(1):e0210398. doi: 10.1371/journal.pone.0210398. eCollection 2019.

Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort.

Author information

Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain.
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
Institute for Culture and Society (ICS), Education of Affectivity and Human Sexuality, University of Navarra, Pamplona, Spain.
Monkole Hospital, Kinshasa, Democratic Republic of Congo.
School of Education and Psychology, University of Navarra, Pamplona, Spain.
Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain.
Microbiology Service, Clínica Universidad de Navarra, Pamplona, Spain.
School of Medicine, University of Mwene-Ditu, Mwene-Ditu, Democratic Republic of the Congo.



Sexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors.


OKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15-59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data.


Among 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting "not" having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors.


Oral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa.

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center