Qualitative research has focused on the contexts surrounding anal intercourse in South Africa 16,17 and Brazil, 18,19 but research on American women's experiences with anal intercourse is sorely lacking. Participants had not used condoms consistently during anal or vaginal intercourse. Most studies of heterosexual HIV transmission fail to distinguish between vaginal and anal intercourse. Nonconsensual anal intercourse occurred with a range of partners, from former husbands and boyfriends to strangers, including men met on the Internet. Consequently, interventions to promote safer anal intercourse must find a way to increase the use of barrier methods without decreasing pleasure or perceived intimacy between sexual partners. So I didn't consider stopping or anything. And here she is again, discussing the pros, cons and surprising new data on women and anal sex in America. For example, when asked if her nonexclusive partner had pressured her to have anal sex, one participant distinguished between male initiative and male pressure:
Three women had used the same condom for vaginal and anal intercourse; another three had used different condoms for vaginal and anal intercourse. A similar dynamic may be at work among women who engage in unprotected anal intercourse to achieve a greater degree of intimacy with their male partners. Aleksander Stulhofer from the University of Zagreb ; and it was centered on young women and sex. In contemporary American sexual culture, the predominant sexual script is one of male pursuit and female acquiescence. I love the spotlight, I love the attention afterwards, the phone calls, even though they're obsessed with me, it makes me feel needed and wanted, and it just makes me feel like a woman. For example, they can limit their number of partners, use a condom from the beginning to the end of sex, change condoms if they are switching between vaginal and anal sex, and use a water-based lubricant to reduce the risk of tearing. My body likes it. Therefore, vaginal and rectal microbicides should be marketed as products that will enhance women's sexual desirability. METHODS In-depth interviews were conducted in Boston in with 28 women who reported having had unprotected anal intercourse in the last year with a man who was HIV-positive or whose serostatus was unknown. Many think of anal sex as being a gay male thing, but surveys show anywhere from 20 to 40 percent of heterosexuals have at least tried it, and the percentage may be increasing. Vernazza PL et al. Nyswander D, Education for health: Of course, the taboo aspect of anal sex may lead to underreporting among those elements of society that don't write in to the newspapers asking about it. Larger societal discourses that focus on the pleasures and risks of penile-vaginal intercourse may also have contributed to participants' tendency to view anal intercourse as less risky than vaginal intercourse. But then when I realized he was trying to go harder and harder with it, then I'm like, okay, that's enough. Sexual Initiative Participants' accounts suggest that their male partners overwhelmingly took the initiative when it came to anal intercourse, consistent with the conventional sexual script. Having made allowances for such things, several large-scale studies estimate that maybe 9 or 10 percent of sexually active American women regularly practice anal sex. Although the sample was ethnically and racially diverse, participation was limited to English-speaking women, and participants were predominantly low-income women. The woman was very familiar with her partner, anal sex was unanticipated or nonconsen-sual, or the partner preferred not to use a condom. Nonconsensual Anal Sex Seven women reported having had nonconsensual anal intercourse at least once. Intimacy and Variety Participants often cited the desire for intimacy or closeness to their partners as either the motivation or the precondition for anal intercourse. Acknowledgments The research on which this article is based was supported by grant R01 —01 from the National Institute of Child Health and Human Development. One thing to be careful about during anal sex is accessories. The codebook was then revised, and one staff member coded the transcripts a second time. Future research is needed to elucidate such relationships. Too often, note Gupta and Weiss, 40 interventions to address high-risk sexual practices collude with existing hierarchies, rather than challenge the underlying structures that contribute to economic and sexual marginalization.
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