Anal sex is a behavioural marker for laboratory-confirmed vaginal sexually transmissible infections and HIV-associated risk among African-American female adolescents

Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Sexual Health (Impact Factor: 1.37). 07/2009; 6(2):111-6. DOI: 10.1071/SH08062
Source: PubMed


African-American females are disproportionately affected by HIV and sexually transmissible infections (STIs). The prevalence of anal sex and its association with other sexual risk behaviours is understudied in this population.
Participants were 715 African-American females, 15 to 21 years old, who had reported sexual activity in the previous 60 days. Data collection included an audiocomputer assisted self-interview (ACASI) and a self-collected vaginal swab specimen assayed using nucleic acid amplification tests to detect the presence of Chlamydia trachomatis and Neisseria gonorrhoeae, and real-time polymerase chain reaction assay to detect Trichomonas vaginalis.
Approximately 10.5% reported anal sex, at least once, during the 60 days before completing the computerised baseline assessment. The prevalence of any STI was significantly greater among adolescents reporting recent anal sex (40% tested positive for at least one of three laboratory-confirmed STIs) relative to those adolescents not reporting anal sex (27.5% STI prevalence). Of the 10 outcomes comprising the sexual risk profile, seven achieved bivariate significance, with each of the differences indicating greater risk for those recently engaging in anal sex. In multivariable controlled analyses, six of the seven measures retained statistical significance.
African-American adolescent females who engage in penile-anal sex may experience an elevated risk of vaginally-acquired STIs. The findings suggest that, among those having penile-anal sex, several HIV/STI-associated sexual risk behaviours are significantly more prevalent. Thus, penile-anal sex may be an important proxy of overall sexual risk behaviours and can be readily assessed during paediatrician visits as part of a sexual history.

20 Reads
  • Source
    • "For males only, sexual orientation related to recent heterosexual anal sex; for females, variables associated with power imbalances in sexual encounters and relationships were identified. In a study of African American young women, DiClemente et al. (2009) found that those who reported anal intercourse (10%) had elevated overall sexual risk behavior. A new ''sexual behavior'' that emerged for study in the last decade was virginity; that is, the active choice to not engage in sexual behavior. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This review details a key innovation across the field of adolescent sexuality research over the last decade—conceptualizing sexuality as a normative aspect of adolescent development. Anchored in a growing articulation of adolescent sexuality as having positive qualities and consequences, we provide an organizing framework for understanding sexuality as normative and developmentally expected. Using this framework, we report on 3 specific areas of research that have developed “critical mass” over the past decade: new views on sexual behavior, sexual selfhood, and sexual socialization in the 21st century. We conclude by suggesting that the next step in the field of adolescent sexuality development is the explicit integration of “positive” dimensions of sexuality with risk management dimensions. Rather than navigating a binary between positive and risky, we propose characterizing the “both/and” quality of adolescent sexuality development as normative. This framework, we argue, encourages empirical research that assumes a wide range of strategies through which adolescents learn about themselves, their bodies, intimate partners, and relationships within contexts where they are required to both manage risks and develop positive patterns for adulthood sexuality. We conclude with considerations for future research and public policy.
    Journal of Research on Adolescence 02/2011; 21(1):242 - 255. DOI:10.1111/j.1532-7795.2010.00726.x · 1.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Young women’s narratives of their sexual experiences occur amid conflicting cultural discourses of risk, abstinence, and moral panic. Yet young women, as social actors, find ways to make meaning of their experiences through narrative. In this study, we focused on adolescent girls’ (N = 98, age 12–17 years) narratives of their first experiences with oral sex. We document our unexpected findings of persistent discourses of performance which echo newly emergent academic achievement discourses. Burns and Torre (Feminism & Psychology 15(1):21–26, 2005) argue that an extreme and high stakes focus on individual academic achievement in schools impoverishes young minds through the “hollowing” of their sexualities. We present evidence that such influence also works in the opposite direction, with an achievement orientation invading girls’ discourses of sexuality, “crowding out” possible narratives of pleasure, choice, and mutuality with narratives of competence and skill usually associated with achievement and schooling. We conclude with policy implications for the future development of “positive” sexuality narratives.
    Sexuality Research and Social Policy: Journal of NSRC 09/2011; 8(3). DOI:10.1007/s13178-011-0062-1 · 0.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The importance of the acceptability of rectal microbicides for HIV and sexually transmissible infections (STIs) prevention is widely recognised. Given relatively consistent use of lubricants for anal intercourse (AI) and the potential for lubricant-like rectal microbicides, understanding barriers to lubricant use may help inform hurdles likely to be encountered once a rectal microbicide becomes available. We conducted an internet-based survey using a 25-item questionnaire to assess AI and lubricant use, including lubricant preferences and barriers to use. The majority of the 6124 respondents who reported AI were male (93%), 25 years or older (80%) and from North America (70%). Consistent condom use during AI was reported by a minority (35%) and consistent lubricant use was reported by over half of respondents. Reasons for non-use differed by age and region. Among men, those <25 years were more likely to report barriers around cost compared with those 45 and older (odds ratio (OR) = 6.64; 95% confidence interval (CI) 3.14-14.03). European men (OR = 1.92; 95% CI 1.50-2.45), Latin American women (OR = 3.69; 95% CI 1.27-10.75) and Asian women (OR = 4.04; 95% CI 1.39-11.78) were more likely to report sexual preference as a reason for non-use. Rectal lubricants are widely used, but barriers to use vary by age and region for dry sex. A lubricant-like rectal microbicide would potentially be acceptable and such a product may be useful as a method of HIV prevention. However, targeted marketing and educational approaches may be needed to enhance use and acceptability of such a product.
    Sexual Health 06/2010; 7(2):193-8. DOI:10.1071/SH09062 · 1.37 Impact Factor
Show more