Prevalence and Correlates of Oral Sex Knowledge and Practice in Malawi

Jason Kerwin, University of Michigan
Sallie Foley, University of Michigan
Jobiba Chinkhumba, University of Malawi
Alinafe Chibwana, Catholic Relief Services, Malawi

Despite medical evidence that female-to-male oral sex carries a much lower risk of HIV transmission than unprotected vaginal intercourse, there has been little research on the practice of fellatio in Africa. We study oral sex in Malawi using a sample of 2753 urban and rural men. Only 55% of rural and 73% of urban men had even heard of the practice and even fewer had ever received fellatio (just 2% (rural) and 12% (urban)). We find that education and condom use predict oral sex knowledge; in contrast, media exposure and beliefs about HIV do not significantly predict knowledge about oral sex after controlling for other confounding factors. The large gap between sexual activity and oral sex prevalence implies substantial scope for fellatio as another safer sex strategy. We also present preliminary results from new data in Malawi validating our results and exploring potential barriers to the use of oral sex.