Correlates of Heterosexual Anal Intercourse Among At-Risk Adolescents and Young Adults

Bradley/Hasbro Children's Research Center, Providence, RI 02903, USA.
American Journal of Public Health (Impact Factor: 4.55). 12/2008; 99(6):1131-6. DOI: 10.2105/AJPH.2007.123752
Source: PubMed


We sought to learn what factors are associated with anal intercourse among adolescents and young adults. We examined demographic, behavioral, relationship context, attitudinal, substance use, and mental health correlates of recent heterosexual anal intercourse among adolescents and young adults who reported engaging in recent unprotected sex.
Among 1348 at-risk adolescents and young adults aged 15 to 21 years in 3 US cities, we assessed sexual risk behavior with each sexual partner in the past 90 days. Data were collected from 2000 to 2001.
Recent heterosexual anal intercourse was reported by 16% of respondents. Females who engaged in anal intercourse were more likely to be living with a sexual partner, to have had 2 or more partners, and to have experienced coerced intercourse. For males, only a sexual orientation other than heterosexual was a significant predictor of engaging in heterosexual anal intercourse.
Our findings document the prevalence of heterosexual anal intercourse among adolescents and young adults who had recent unprotected sex. Among females, the variables associated with anal intercourse relate to the context and power balance of sexual relationships. Different influences for males and females suggest different foci for interventions.

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Available from: Celia M Lescano, Aug 13, 2014
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    • "exacerbated by low rates of condom use among heterosexual men and women (Gorbach et al., 2009a; Leichliter, Chandra, Liddon, Fenton, & Aral, 2007; Lescano et al., 2009; Maynard, Carballo-Dieguez, Ventuneac, Exner, & Mayer, 2009; Tian et al., 2008). In a U.S. sample, 63 % of heterosexual men and women reported never using condoms for anal sex (Tian et al., 2008). "
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    ABSTRACT: Most studies of heterosexual sex risk practices have focused on condomless vaginal sex despite evidence that condomless anal sex has a significantly higher risk of HIV transmission. The present study focused on male clients' anal sex practices with female sex workers (FSWs) in Tijuana, Mexico, where an HIV epidemic is growing among high-risk groups. Logistic regression analyses were used to identify psychosocial and behavioral correlates of anal sex among male clients. Our sample of HIV-negative men (N = 400) was predominantly Latino (87.5 %), born in Mexico (78.8 %), never married (36.8 %) or in a regular or common-law marriage (31.5 %), and employed (62.8 %), with an average age and education of 37.8 and 9.2 years, respectively. Eighty-nine percent identified as heterosexual and 11 % as bisexual. By design, 50 % of the sample resided in Tijuana and the other 50 % in San Diego County. Nearly half (49 %) reported at least one incident of anal sex with a FSW in Tijuana in the past 4 months; of those participants, 85 % reported that one or more of their anal sex acts with FSWs had been without a condom. In a multivariate model, anal sex with a FSW in the past 4 months was associated with bisexual identification, methamphetamine use with FSWs, repeat visits to the same FSW, higher scores on perceived stigma about being a client of FSWs, and sexual compulsivity. Prevention programs are needed that address the behavioral and psychosocial correlates of heterosexual anal sex in order to reduce HIV/STI transmission risk among male clients, FSWs, and their sexual network members.
    Full-text · Article · Mar 2015 · Archives of Sexual Behavior
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    • "Unprotected anal intercourse carries the highest risk of HIV transmission as compared to oral and vaginal sex [22]. It was pointed out that between 3% and 41% of girls and between 7% and 20% of boys reported having engaged in anal sex [23,24]. It was identified that 5.0% of young people in Nigeria and 7.5% of students in Tanzania had anal intercourse [19,25]. "
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    ABSTRACT: Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. The overall proportion of people who reported ever having oral sex was 5.4% (190) and that of anal sex was 4.3% (154). Of these 51.6% (98) had oral sex and 57.1% (87) had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2) and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5). Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4), and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7). Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to cover a full range of sexual practices.
    Full-text · Article · Jan 2012 · BMC Public Health
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    • "More recently, research has examined the role and expectations surrounding anal sex. Lescano et al. (2009) "
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    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.
    Full-text · Article · Feb 2011 · Journal of Research on Adolescence
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