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Risk for HIV, STDs associated with anal intercourse merits more attention by health care providers of young adults
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As many as one-third of young adults may have had anal intercourse, according to findings presented at the 2009 National HIV Prevention Conference, held in Atlanta.
Marion Carter, PhD, of the Division of Reproductive Health at CDC, presented the results. “Most providers and educators do not discuss heterosexual anal intercourse with patients,” she said.
Researchers reported on quantitative and qualitative data from 70 individual coital diaries and 482 participants in a community-based survey of Puerto Rican and black urban youth aged 18 to 25 years in Philadelphia and Hartford, Conn.
Experience with anal intercourse was reported by 33% of participants. The median age of the first anal intercourse experience was 17 years old. Puerto Rican participants were more likely to have had anal intercourse than black participants (42% vs. 26%).
Of the 400 participants who reported having a serious partner in the previous six months, 22% reported ever having anal intercourse with that partner. Among that 22%, 67% reported never using a condom for any anal intercourse experiences in the past six months.
There were 170 respondents who had a casual partner in the previous six months, 8% of whom reported ever having anal intercourse with that partner.
Carter discussed some of the reasons why participants did or did not have anal intercourse.
“There were mostly negative perceptions about anal sex in the dairies,” she said. “Some men and women expressed an aversion to idea of anal sex, and some acknowledged that they or their partners found it to be painful.”
Carter said that there were no clear patterns in the reasons for or against anal intercourse related to race or ethnicity. However, black respondents were more likely to mention negative connotations to the association of anal intercourse with homosexuality.
Among the reasons to engage in anal intercourse, pleasure was near the top, according to Carter. She also said that the act was seen as an integral part of relationship building for some people.
“Some women said that having anal intercourse and other sexual behaviors provided sexual variety, which they thought would increase the likelihood that their partner will stick around or at least be willing to keep the relationship going,” Carter said. “Others reported that the act of anal sex itself communicated relationship seriousness and intimacy.”
Carter said that the desire to avoid pregnancy or to have sex during menstruation also were reasons for engaging in anal intercourse, but these reasons appeared minor among the participants in these data.
The primary reason cited for not using a condom during anal intercourse was that the risk of disease transmission for a particular partner was perceived to be low. Concerns about hygiene or STD transmission prompted condom use for others.
Carter closed with some recommendations for clinicians.
“We should expect clients to have or be considering anal sex, and we should not assume that it’s an extreme behavior,” she said. “So, therefore, we should discuss the risks of HIV or STDs involved and promote condom use at the same time as we do for vaginal sex.”
For more information:
- Carter M. A03-3. Presented at: 2009 National HIV Prevention Conference; Aug. 23-26, 2009; Atlanta.