Journal articles: 'Heterosexual Anal Sex'

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Risser, J. M. H., P. Padgett, M. Wolverton, and W. L. Risser. "Relationship between heterosexual anal sex, injection drug use and HIV infection among black men and women." International Journal of STD & AIDS 20, no. 5 (May 2009): 310–14. http://dx.doi.org/10.1258/ijsa.2008.008394.

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US blacks carry a disproportionate risk of heterosexually transmitted HIV. This study aimed to evaluate the association between self-reported heterosexual anal intercourse and HIV. Using respondent-driven sampling (RDS), we recruited and interviewed 909 blacks from areas of high poverty and HIV prevalence in Houston, Texas, and who reported heterosexual sex in the last year. All individuals were tested for HIV. Weighted prevalence values were calculated to account for non-random recruitment associated with RDS. The weighted population prevalence of HIV infection was 2.4% and 2.5% among men and women, respectively. Education, employment status, income and crack cocaine use were not associated with HIV infection. Lifetime injection drug use (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31–8.33%) and heterosexual anal intercourse (OR 2.41, 95% CI 1.02–5.73%) were associated with HIV infection. Individuals who reported both injection drug use and heterosexual anal intercourse had 6.21 increased odds of HIV (95% CI 2.47–15.61%). Our results suggest that heterosexual anal sex may be a vector for HIV transmission, especially in the context of injection drug use. Prevention strategies directed at curbing the HIV epidemic among black heterosexuals require that we correctly identify the risks so that appropriate interventions can be developed.

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Heywood, Wendy, and Anthony M. A. Smith. "Anal sex practices in heterosexual and male homosexual populations: a review of population-based data." Sexual Health 9, no. 6 (2012): 517. http://dx.doi.org/10.1071/sh12014.

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Anal sex is known to be an important risk factor for anal cancer. Yet compared with vaginal intercourse, little is known about anal sex practices in either heterosexual or male homosexual populations. Of the data that are available, it appears a significant and increasing minority of heterosexuals have ever practised anal intercourse. Among homosexual men, most, but not all, report anal sex, with large proportions of men engaging in both insertive and receptive anal intercourse. The most significant finding of the review was the dearth of population-based data, particularly relating to homosexual men.

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McBride, Kimberly R., and J. Dennis Fortenberry. "Heterosexual Anal Sexuality and Anal Sex Behaviors: A Review." Journal of Sex Research 47, no. 2-3 (March 24, 2010): 123–36. http://dx.doi.org/10.1080/00224490903402538.

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Fahs, Breanne, and Jax Gonzalez. "The front lines of the “back door”: Navigating (dis)engagement, coercion, and pleasure in women’s anal sex experiences." Feminism & Psychology 24, no. 4 (June 27, 2014): 500–520. http://dx.doi.org/10.1177/0959353514539648.

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Despite the frequent depiction of heterosexual anal sex in pornography, and growing indications that heterosexual couples engage in anal sex, almost no research has examined women’s subjective experiences with receptive anal sex with men. This study draws upon qualitative interviews with 20 American women (mean age = 34, SD = 13.35) from diverse ages and backgrounds to illuminate five themes in women’s narratives about receptive anal sex: (1) initial resistance followed by submission; (2) initial interest followed by withdrawal from subsequent anal sex experiences; (3) violence and coercion surrounding anal sex; (4) social norming (e.g. men’s male friends normalizing heterosexual anal sex; seeing anal sex as normative after watching pornography); and (5) pleasurable experiences with anal eroticism. Implications for the re-evaluation of consent, imagining a continuum of sexualized violence, heteronormative assumptions about access to and power over women, silences surrounding non-penetrative anal eroticism, and women’s (dis)engagement with anal sex are explored.

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Leichliter, Jami S. "Heterosexual Anal Sex: Part of an Expanding Sexual Repertoire?" Sexually Transmitted Diseases 35, no. 11 (November 2008): 910–11. http://dx.doi.org/10.1097/olq.0b013e31818af12f.

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Štulhofer, Aleksandar, and Valerio Baćak. "Is anal sex a marker for sexual risk-taking? Results from a population-based study of young Croatian adults." Sexual Health 8, no. 3 (2011): 384. http://dx.doi.org/10.1071/sh10078.

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Background There is evidence that anal sex is becoming increasingly popular among heterosexual women and men. Several studies carried out in especially vulnerable populations (e.g. sex workers and low-income youth) suggested that anal sex may indicate a more general propensity to sexual risk-taking. Methods: To assess whether this epidemiologically important finding holds in the case of young adults from the general population, we analysed data from a cross-sectional probability survey carried out in 2010 on 1005 Croatian women and men aged 18–25. Results: Anal intercourse was reported by 36.5% of 861 sexually experienced participants (42.7% of men and 29.8% of women). About one-third of them (34%) used a condom at most recent anal intercourse. The experience of anal sex was significantly associated (P < 0.001) with all four indicators of sexual risk-taking (condom use at most recent vaginal intercourse, number of sexual partners in the past year, concurrent sexual relationships and anonymous sex in the past year), as well as with negative attitudes and beliefs about condom use (P < 0.01). Sexual sensation-seeking mediated the relationship between anal sex and some of the sexual risk-taking behaviours. Conclusion: According to the findings, heterosexual anal sex is directly and indirectly associated with increased behavioural risks of acquiring HIV and other sexually transmissible infections (STI). Sex education and STI prevention programs should focus on the importance of using protection when practicing anal sex.

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Edwards, S. "Heterosexual Transmission of HIV Facilitated by Anal Sex and Sex During Menses." Family Planning Perspectives 24, no. 5 (September 1992): 237. http://dx.doi.org/10.2307/2135882.

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Rissel, Chris, Paul B. Badcock, Anthony M. A. Smith, Juliet Richters, Richard O. de Visser, Andrew E. Grulich, and Judy M. Simpson. "Heterosexual experience and recent heterosexual encounters among Australian adults: the Second Australian Study of Health and Relationships." Sexual Health 11, no. 5 (2014): 416. http://dx.doi.org/10.1071/sh14105.

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Background Current information about numbers of other-sex partners, experiences of different heterosexual behaviours and the recent heterosexual experiences among a representative sample of Australian adults is needed. It is not known whether these practices have changed between 2001–02 and 2012–13. Methods: Computer-assisted telephone interviews were completed by a representative sample of 9963 men and 10 131 women aged 16–69 years from all states and territories. The overall participation rate among eligible people was 66.2%. Results: Men reported more sexual partners than women, although the lifetime number of heterosexual partners reported by women increased significantly between 2001–02 and 2012–13. In 2012–13, 14.7% of men and 8.6% of women reported two or more sexual partners in the last year. Reporting multiple partners was significantly associated with being younger, being bisexual, living in major cities, having a lower income, having a blue-collar occupation and not being married. The proportion of respondents reporting ever having had oral sex or anal intercourse increased significantly since the last survey. At the last heterosexual encounter, 91.9% of men and 66.2% of women had an orgasm, oral sex was reported in only approximately one in four encounters and anal intercourse was uncommon. Conclusion: There were increases between 2001–02 and 2012–13 in partner numbers among women and in the lifetime experience of oral and anal sex. The patterns of heterosexual experience in Australia are similar to those found in studies of representative samples in other countries.

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Rissel, Chris, Paul B. Badcock, Anthony M. A. Smith, Juliet Richters, Richard O. de Visser, Andrew E. Grulich, and Judy M. Simpson. "Corrigendum to: Heterosexual experience and recent heterosexual encounters among Australian adults: The Second Australian Study of Health and Relationships." Sexual Health 12, no. 6 (2015): 568. http://dx.doi.org/10.1071/sh14105_co.

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Background Current information about numbers of other-sex partners, experiences of different heterosexual behaviours and the recent heterosexual experiences among a representative sample of Australian adults is needed. It is not known whether these practices have changed between 2001–02 and 2012–13. Methods: Computer-assisted telephone interviews were completed by a representative sample of 9963 men and 10 131 women aged 16–69 years from all states and territories. The overall participation rate among eligible people was 66.2%. Results: Men reported more sexual partners than women, although the lifetime number of heterosexual partners reported by women increased significantly between 2001–02 and 2012–13. In 2012–13, 14.7% of men and 8.6% of women reported two or more sexual partners in the last year. Reporting multiple partners was significantly associated with being younger, being bisexual, living in major cities, having a lower income, having a blue-collar occupation and not being married. The proportion of respondents reporting ever having had oral sex or anal intercourse increased significantly since the last survey. At the last heterosexual encounter, 91.9% of men and 66.2% of women had an orgasm, oral sex was reported in only approximately one in four encounters and anal intercourse was uncommon. Conclusion: There were increases between 2001–02 and 2012–13 in partner numbers among women and in the lifetime experience of oral and anal sex. The patterns of heterosexual experience in Australia are similar to those found in studies of representative samples in other countries.

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Fahs, Breanne, Eric Swank, and Lindsay Clevenger. "Troubling Anal Sex: Gender, Power, and Sexual Compliance in Heterosexual Experiences of Anal Intercourse." Gender Issues 32, no. 1 (October 22, 2014): 19–38. http://dx.doi.org/10.1007/s12147-014-9129-7.

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Chow, Eric P. F., Rebecca Wigan, Anna McNulty, Charlotte Bell, Mandy Johnson, Lewis Marshall, David G. Regan, et al. "Early sexual experiences of teenage heterosexual males in Australia: a cross-sectional survey." BMJ Open 7, no. 10 (October 2017): e016779. http://dx.doi.org/10.1136/bmjopen-2017-016779.

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ObjectiveThere are limited data on the patterns of early sexual behaviours among Australian teenage heterosexual boys. This study describes the nature and onset of early sexual experiences in this population through a cross-sectional survey.DesignA cross-sectional survey between 2014 and 2015SettingMajor sexual health clinics and community sources across AustraliaParticipantsHeterosexual men aged 17–19 yearsResultsThere were 191 men in the study with a median age of 19.1 years. Median age at first oral sex was 16.4 years (IQR: 15.5–17.7) and 16.9 years (IQR: 16.0–18.0) for first vaginal sex. Most men had engaged in oral sex (89.5%) and vaginal sex (91.6%) in the previous 12 months with 32.6% reporting condom use at last vaginal sex. Of the total lifetime female partners for vaginal sex reported by men as a group (n=1187): 54.3% (n=645) were the same age as the man, 28.3% (n=336) were a year or more younger and 17.4% (n=206) were a year or more older. Prior anal sex with females was reported by 22% with 47% reporting condom use at last anal sex. Median age at first anal sex was 18.2 years (IQR: 17.3–18.8). Anal sex with a female was associated with having five or more lifetime female sexual partners for oral and vaginal sex.ConclusionsThese data provide insights into the trajectory of sexual behaviours experienced by teenage heterosexual boys following sexual debut, findings which can inform programme promoting sexual health among teenage boys.

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Moscicki, Anna-Barbara, Yifei Ma, Sepideh Farhat, Julie Jay, Evelyn Hanson, Susanna Benningfield, Janet Jonte, Cheryl Godwin-Medina, Robert Wilson, and Stephen Shiboski. "27. Natural history of anal HPV in heterosexual women and risks associated with persistence." Sexual Health 10, no. 6 (2013): 583. http://dx.doi.org/10.1071/shv10n6ab27.

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Background Anal cancer is more common in women than in men, yet little is known about the natural history of HPV in women. The objective was to examine the natural history of anal HPV in heterosexual women and to examine risk factors associated with persistence. Methods: Young women participating in a HPV cohort study were seen at 4-month intervals for cervical and anal testing for HPV DNA. The distribution of time to clearance was estimated using the Kaplan–Meier approach, and risks for persistence assessed using Cox regression models. Results: Seventy-five women (mean age 23.5 ± 4.1 years) who tested positive for anal HPV were followed for a mean of 84.5 ± 44.9 months. By 3 years, 82.5% of anal non-16 high risk (HR) HPV, 82.6% of low risk (LR) HPV and 76.2% of HPV16 infections had cleared. By 3 years, only 36.4% of women had become negative for all HPV types. In the multivariable model, concurrent cervical HPV 16 (P = 0.009) or any HR HPV (P = 0.046) detection, weekly alcohol use (P = 0.018), anal touching during sex (P = 0.034), and ever having anal sex (P = 0.06) were associated with HPV 16 persistence. Having a new sex partner (P < 0.001) and condom use during vaginal sex (P = 0.06) were associated with clearance. Similar associations were found for clearance all HR HPV infections. Only concomitant cervical HPV infection was associated with non-16 HR HPV persistence. Conclusions: The majority of anal HPV infections cleared within 3 years. HPV 16 infections were slower to clear than other HR HPV, consistent with its role in anal cancer. Sexual behaviour was associated with persistence, suggesting that education and behavioural interventions may decrease persistence and the risk of anal cancer.

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Inciardi, James A., and Hilary L. Surratt. "Male Transvestite Sex Workers and HIV in RIO De Janeiro, Brazil." Journal of Drug Issues 27, no. 1 (January 1997): 135–46. http://dx.doi.org/10.1177/002204269702700109.

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The aims of this study were to assess the prevalence of HIV-1 infection among a group of transvestite prostitutes in Rio de Janeiro and to identify HIV-related risk behaviors to develop targeted intervention strategies. A total of 46 transvestite sex workers were recruited and assessed regarding drug use and sexual risk behaviors. Sixty-three percent tested positive for antibody to HIV-I. Injection drug use was the only factor statistically related to HIV seropositivity. However, sexual risk behaviors, including unprotected anal sex and sex for drug exchanges, were reported by a substantial part of the sample. In addition, given that they engage in both receptive and insertive anal sex with a primarily heterosexual male clientele, they may be playing a role in the heterosexual spread of HIV/AIDS in Brazil. The results of this study suggest that transvestite sex workers are at uniquely high risk for HIV infection and that intervention efforts for this population must be equally unique.

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Carter, Marion, Dare Henry-Moss, Linda Hock-Long, Anna Bergdall, and Karen Andes. "Heterosexual Anal Sex Experiences Among Puerto Rican and Black Young Adults." Perspectives on Sexual and Reproductive Health 42, no. 4 (November 3, 2010): 267–74. http://dx.doi.org/10.1363/4226710.

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McBride, Kimberly R. "Heterosexual Women’s Anal Sex Attitudes and Motivations: A Focus Group Study." Journal of Sex Research 56, no. 3 (August 10, 2017): 367–77. http://dx.doi.org/10.1080/00224499.2017.1355437.

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Raj, Anita, Elizabeth Reed, Seth L. Welles, Maria Christina Santana, and Jay G. Silverman. "Intimate Partner Violence Perpetration, Risky Sexual Behavior, and STI/HIV Diagnosis Among Heterosexual African American Men." American Journal of Men's Health 2, no. 3 (August 29, 2008): 291–95. http://dx.doi.org/10.1177/1557988308320269.

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Evidence indicates that abusive male partners pose increased risk for sexually transmitted infection (STI)/HIV among females. However, research with males on this issue is limited. The objective of this study was to assess the associations between intimate partner violence (IPV) perpetration and recent STI/HIV diagnosis, unprotected sex, and sex trade involvement among heterosexual African American men. In this cross-sectional study, heterosexual African American males aged 18 to 65 years who reported two or more sex partners in the past year were recruited from urban health clinics to complete a computerized survey assessing sociodemographic characteristics, IPV perpetration history, risky sexual behaviors, and substance use. Multivariate logistic regression analyses assessed associations between IPV perpetration and STI/HIV risk. More than half of participants in this sample (61%) were unemployed; 28.2% had less than a high school education and 23.1% were homeless. One-fifth of the sample (21.2%) reported IPV perpetration in their current relationship. IPV perpetration was significantly associated with recent STI/HIV diagnosis, unprotected anal sex, and buying sex. IPV perpetration is pervasive among heterosexually at-risk African American men presenting for clinical care, and those perpetrating IPV are at heightened risk for STI/HIV.

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CHOW, E. P. F., A. C. LIN, T. R. H. READ, C. S. BRADSHAW, M. Y. CHEN, and C. K. FAIRLEY. "Ratio of anogenital warts between different anatomical sites in homosexual and heterosexual individuals in Australia, 2002–2013: implications for susceptibility of different anatomical sites to genital warts." Epidemiology and Infection 143, no. 7 (August 19, 2014): 1495–99. http://dx.doi.org/10.1017/s0950268814002118.

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SUMMARYThere is little known regarding the transmissibility of human papillomavirus (HPV) between different sites in men who have sex with men (MSM) and heterosexual individuals. We conducted a retrospective analysis investigating all new patients attending the Melbourne Sexual Health Centre in Australia between 2002 and 2013. We describe the prevalence and ratio of the first episode of anogenital warts in MSM and heterosexual males and females. The proportion of new MSM clients with anal and penile warts was 4·0% (362/8978) and 1·6% (141/8978), respectively; which gave an anal-to-penile wart ratio of 1:2·6. About 13·7% (1656/12112) of heterosexual males had penile warts and 10·0% (1121/11166) of females had vulval warts, which yielded a penile-to-vulval wart ratio of 1:0·7. Penile–anal transmission has a higher ratio than penile–vulval transmission, suggesting that the anal epithelium may be more susceptible to HPV infection than the vulval epithelium in females; these ratios are important in modelling the control of HPV in MSM.

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Galea, Jerome T., Segundo R. León, Jesús Peinado, Gino Calvo, Jonathan Zamora, Hugo Sánchez, and Brandon J. Brown. "HPV knowledge, burden and genital wart location among heterosexually identified versus homosexually identified men who have sex with men in Lima, Peru: cross-sectional results from a cohort study." BMJ Open 7, no. 10 (October 2017): e017338. http://dx.doi.org/10.1136/bmjopen-2017-017338.

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ObjectivesThe relationship between sexual practices, identity and role among Latino men who have sex with men (MSM) and HIV risk is the subject of ongoing investigation but less is known about how these aspects of sexuality relate to human papilloma-virus (HPV), an independent risk factor for HIV. This observational study investigated the relationship between HPV and sexual practices, identity and role as well as other sexually transmitted infection (STI)/HIV risk factors among HIV-negative heterosexually and homosexually identified Peruvian MSM.SettingCommunity-based clinic for MSM in Lima, Peru.Participants756 subjects were screened based on inclusion criteria of: born anatomically male; age ≥18 years; had any anal intercourse with a man during the previous 12 months; residing in metropolitan Lima; HIV negative; willing to commit to twice-yearly clinic visits for 24 months; had not participated in an HIV or HPV vaccine study. 600/756 participants met the inclusion criteria and were enrolled, of whom 48% (284) identified as homosexual and 10% (57) as heterosexual, the basis of the analyses performed.ResultsCompared with homosexually identified MSM, heterosexually identified MSM had completed fewer years of formal education and were less likely to have: anogenital HPV or visible anal warts; given oral sex to a man; or used a condom with their most recent female sexual partner (all p<0.05). Conversely, heterosexually identified MSM were more likely to have: visible penile warts; used a condom during last anal intercourse; smoked cigarettes; had transactional sex; and used drugs during sex in the previous month (all p<0.01). There was no difference found between heterosexually and homosexually identified MSM by syphilis or high-risk HPV prevalence.ConclusionsHPV burden, wart type (penile vs anal) and select HIV/STI risk behaviours differed between heterosexually and homosexually identified Peruvian MSM. Understanding the implications of these differences can lead to tailored HIV/STI prevention interventions for heterosexually identified MSM.Trial registration numberNCT01387412.

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Fairley, Christopher K., Julia M. L. Brotherton, Richard Hillman, and Andrew E. Grulich. "Why a special issue on anal cancer and what is in it?" Sexual Health 9, no. 6 (2012): 501. http://dx.doi.org/10.1071/sh12109.

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This editorial describes the contents of this special issue of Sexual Health devoted to anal cancer. The aim of the issue is to provide readers with information to assist them in making decisions about what to do about detecting anal cancer early in men who have sex with men with HIV. Should they be advocating screening? It discusses the epidemiology of HPV infection, anal intraepithelial neoplasia, and anal cancer in MSM, heterosexual men and women; anal cancer screening and treatment of anal cancer. And most importantly, what should be done about vaccinating boys with the HPV vaccine.

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Tian, Lin H., Thomas A. Peterman, Guoyu Tao, Lesley C. Brooks, Carol Metcalf, C. Kevin Malotte, Sindy M. Paul, and John M. Douglas. "Heterosexual Anal Sex Activity in the Year After an STD Clinic Visit." Sexually Transmitted Diseases 35, no. 11 (November 2008): 905–9. http://dx.doi.org/10.1097/olq.0b013e318181294b.

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McBride, Kimberly R., Stephanie A. Sanders, Brandon J. Hill, and June M. Reinisch. "Heterosexual Women’s and Men’s Labeling of Anal Behaviors as Having “Had Sex”." Journal of Sex Research 54, no. 9 (February 23, 2017): 1166–70. http://dx.doi.org/10.1080/00224499.2017.1289362.

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Colón-López, Vivian, Ana Patricia Ortiz, Lizbeth Del Toro-Mejías, Michael Craig Clatts, and Joel M. Palefsky. "6. Prevalence, genotype diversity and determinants of anal HPV infection in high-risk men attending a sexually transmitted infection clinic in Puerto Rico." Sexual Health 10, no. 6 (2013): 572. http://dx.doi.org/10.1071/shv10n6ab6.

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Background Recent studies in Puerto Rico (PR) have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among heterosexual men and men who have sex with men (MSM) attending an STI clinic in PR. Methods: We conducted a cross-sectional study of men 18 years and older. A comprehensive survey was administered that included a demographic and behavioural assessment. Logistic regression was performed to determine factors associated with any, high-risk (HR), low-risk (LR) and multiple anal HPV infection. Results: The mean age of the study sample was 38.0 ± 13.5 and 37.7 ± 13.0 years for MSM and heterosexual men, respectively. A third (29.8%) of the study sample reported being MSM. Significant differences were observed in the prevalence of any anal HPV infection for MSM (84.5%) as compared with heterosexual men (45.7%; P < 0.001). Although MSM showed a higher prevalence of both HR and LR HPV types, no significant differences were observed in the bivariate analysis. Overall, HR anal HPV infection was found in 58.5% of the participants. The most common HR types were 53, 58, 68, 51 and 31. Multiple HPV types in the anal canal were found in 50.0% of the sample. Multivariate logistic regression analysis showed that being a MSM was associated with any anal HPV infection (OR = 6.2; 95% CI 1.5, 25.7). Conclusions: Anal HPV is common among sexually active men attending this STI clinic, with a higher likelihood of any anal HPV infection among MSM.

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Livak, Britt S., Nikhil G. Prachand, and Nanette Benbow. "Anal Intercourse and HIV Risk Among Low-Income Heterosexual Women: Findings from Chicago HIV Behavioral Surveillance." Open AIDS Journal 6, no. 1 (September 7, 2012): 142–48. http://dx.doi.org/10.2174/1874613601206010142.

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Background:Anal intercourse (AI) is a highly efficient route for HIV transmission and has not been well elucidated among heterosexual (HET) women. Heterosexual women living in impoverished urban areas in the US are at increased risk for HIV acquisition. We aim to describe rates of AI and characteristics associated with AI among heterosexual women at increased risk for HIV acquisition living in Chicago.Methods:The Chicago Department of Public Health conducted a survey of HET during 2007 as part of the National HIV Behavioral Surveillance System. Venue-based, time-location sampling was used to select participants from venues in high-risk areas (census tracts with concurrently high rates of heterosexual AIDS and household poverty). Eligible participants were interviewed anonymously and offered a HIV test.Results:In total, 407 heterosexual women were interviewed. Seventy-one (17%) women reported having AI in the past 12 months, with 61 of the 71 (86%) reporting unprotected AI. In multivariate analysis, women who engaged in AI were more than three times as likely to have three or more sex partners in the past 12 months (OR=3.27, 95% CI 1.53-6.99). AI was also independently associated with STI diagnosis in the past 12 months (2.13, 95% CI 1.06-4.26), and having sexual intercourse for the first time before the age of 15 years (2.23, 95% CI 1.28-3.89).Conclusion:AI was associated with multiple high risk behaviors including a greater number of sexual partners, STI diagnosis, and earlier age at first sex. The combination of risk factors found to be associated with AI call for new HIV prevention services tailored to the needs of women and young girls living in poverty.

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Wuytack, Francesca, Vittoria Lutje, Janus Christian Jakobsen, Karl Heinz Weiss, Paula Flanagan, Georgina Gethin, Louise Murphy, Siobhan Smyth, Declan Devane, and Valerie Smith. "Sexual transmission of Hepatitis C Virus infection in a heterosexual population: A systematic review." HRB Open Research 1 (March 8, 2018): 10. http://dx.doi.org/10.12688/hrbopenres.12791.1.

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Background: Hepatitis C virus (HCV) infection is an important cause of liver disease worldwide. Identification of risk factors can guide screening and prevention. Sexual transmission in monogamous heterosexual relationships is rare but it is uncertain which sexual behaviours are linked to HCV transmission. This review aimed to determine risk factors for sexual HCV transmission in heterosexuals in low HCV prevalence countries (PROSPERO registration CRD42016051099). Methods: We searched Medline, Embase, Science Citation Index-Expanded, Social Sciences Citation index, Conference proceedings (Web of Science), CINAHL, Scopus, LILACS, PubMed, and grey literature (04/11/2016). We included studies published in/after the year 2000 that examined sexual risk factors for HCV infection, other than interspousal transmission, in heterosexual adults (≥18 years). We excluded prisoners, people who inject drugs (PWIDs), people co-infected with HIV or from high prevalence countries. Two reviewers completed study selection, data extraction, risk of bias and quality of evidence assessment (GRADE) independently. Meta-analysis could not be conducted. Results: Eight studies were included, examining seven factors (multiple sex partners, receiving/providing sex commercially, PWID partner, and unprotected vaginal, oral, anal sex). None were significant, except the evidence for the factor having a PWID partner was conflicting. Conclusions: We are uncertain about the results due to the very low quality of evidence (GRADE). A more liberal approach to review inclusion criteria might be useful in further identifying factors associated with an increased risk of sexual transmission of HCV infection in a heterosexual population. However, caution should be applied to avoid the impact of confounders on the findings.

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Brown, J., K. Hess, S. Brown, C. Murphy, A. Waldman, and M. Hezareh. "P1-S5.01 Heterosexual Anal Sex, Lubrication, HIV, and HSV-2 infection among women." Sexually Transmitted Infections 87, Suppl 1 (July 1, 2011): A175. http://dx.doi.org/10.1136/sextrans-2011-050108.179.

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Carlos, Silvia, Cristina López-del Burgo, Adolphe Ndarabu, Alfonso Osorio, Anaïs Rico-Campà, Gabriel Reina, Eduardo Burgueño, and Jokin de Irala. "Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort." PLOS ONE 14, no. 1 (January 16, 2019): e0210398. http://dx.doi.org/10.1371/journal.pone.0210398.

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Duby, Zoe, and Christopher Colvin. "Conceptualizations of Heterosexual Anal Sex and HIV Risk in Five East African Communities." Journal of Sex Research 51, no. 8 (March 10, 2014): 863–73. http://dx.doi.org/10.1080/00224499.2013.871624.

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Strang, John, Beverly Powis, Paul Griffiths, and Michael Gossop. "Heterosexual Vaginal and Anal Intercourse Amongst London Heroin and Cocaine Users." International Journal of STD & AIDS 5, no. 2 (March 1994): 133–36. http://dx.doi.org/10.1177/095646249400500211.

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A community-derived sample of 392 heroin users and 145 cocaine users were interviewed about their drug use and sexual behaviour, with (optional) collection of saliva specimen for linked anonymous HIV/HBV testing. The heroin sample was stratified (50/50) across current treatment and non-treatment status. For cocaine users 80% were not in current contact with any treatment. Overall levels of sexual activity were several times higher than reported in recent national surveys. Last-year prevalence of heterosexual anal intercourse was 23% and 20% for heroin-using males and females respectively (last-month figures—12% and 10%); and 23% and 15% for cocaine-using males and females respectively (last-month figures—7% and 9%). Two-thirds of subjects rarely or never used condoms during heterosexual anal intercourse. For females, receptive anal intercourse was positively related to a history of sex-for-money activity, high scores of severity of dependence, and injecting as a current route of use.

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Martín-Sánchez, Mario, Richard Case, Christopher Fairley, Jane S. Hocking, Catriona Bradshaw, Jason Ong, Marcus Y. Chen, and Eric P. F. Chow. "Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia." BMJ Open 10, no. 11 (November 2020): e037608. http://dx.doi.org/10.1136/bmjopen-2020-037608.

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ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.

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Reynolds, Grace L., Dennis G. Fisher, Lucy E. Napper, Brent W. Fremming, and Michael A. Jansen. "Heterosexual Anal Sex Reported by Women Receiving HIV Prevention Services in Los Angeles County." Women's Health Issues 20, no. 6 (November 2010): 414–19. http://dx.doi.org/10.1016/j.whi.2010.07.006.

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Alexander, Mallika, Mandar Mainkar, Sucheta Deshpande, Shweta Chidrawar, Suvarna Sane, and Sanjay Mehendale. "Heterosexual Anal Sex among Female Sex Workers in High HIV Prevalence States of India: Need for Comprehensive Intervention." PLoS ONE 9, no. 2 (February 20, 2014): e88858. http://dx.doi.org/10.1371/journal.pone.0088858.

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Evers, Ymke J., Nicole H. T. M. Dukers-Muijrers, Carolina J. G. Kampman, Geneviève A. F. S. van Liere, Jeannine L. A. Hautvast, Femke D. H. Koedijk, and Christian J. P. A. Hoebe. "Prevalence of drug use during sex among swingers and perceived benefits and risks – a cross-sectional internet survey in the Netherlands." Sexually Transmitted Infections 96, no. 1 (August 12, 2019): 40–46. http://dx.doi.org/10.1136/sextrans-2019-054113.

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ObjectivesDrug use during sex has been associated with sexually transmitted infections (STI). While a growing body of research has investigated drug use during sex among men who have sex with men, data in swingers is limited. Swingers are heterosexual couples who have sex with others and singles who have sex with these couples. Our study assessed the prevalence of drug use during sex and perceived benefits and risks among swingers.MethodsIn 2018, 1005 swingers completed an online questionnaire that was advertised at Dutch swinger-websites. We assessed the associations between drug use during sex <6 months (any drug use excluding alcohol and erection medicines) and sociodemographic characteristics, alcohol use and condomless sex using backward multivariable logistic regression analysis. We compared drug use, motives, beliefs and experienced effects between heterosexual male, bisexual male and female drug-using swingers using χ2-tests.ResultsDrug use during sex was reported by 44% (443/1005): 51% in women, 44% in bisexual men and 39% in heterosexual men (P<0.01). Condomless vaginal (46%) and anal sex (22%) was higher in drug-using swingers (vs 34% and 13% in non-drug-using swingers, P<0.001). Among drug-using swingers, XTC (92%), GHB (76%) and laughing gas (69%) were mostly used. Prolonging sex (68%) and increasing arousal (66%) were the most reported motives. Most reported positive effects were feeling happy (78%) and increasing energy (78%). Ninety-four per cent considered drug use to be pleasurable. The most reported negative effect was feeling tired (53%), 7% reported that they might become addicted or felt uncomfortable having sex without drugs.ConclusionThis study among a large group of swingers shows that drug use during sex is highly prevalent. STI clinics should discuss drug use during sex among swingers and provide information on safer sex and drug use, while acknowledging the perceived benefits, such as the increased quality of sex.

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Habel, Melissa A., Jami S. Leichliter, Patricia J. Dittus, Ian H. Spicknall, and Sevgi O. Aral. "Heterosexual Anal and Oral Sex in Adolescents and Adults in the United States, 2011–2015." Sexually Transmitted Diseases 45, no. 12 (December 2018): 775–82. http://dx.doi.org/10.1097/olq.0000000000000889.

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Stadler, J. J., S. Delany, and M. Mntambo. "Sexual coercion and sexual desire: Ambivalent meanings of heterosexual anal sex in Soweto, South Africa." AIDS Care 19, no. 10 (November 2007): 1189–93. http://dx.doi.org/10.1080/09540120701408134.

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Calsyn, Donald A., Mary A. Hatch-Maillette, Christina S. Meade, Susan Tross, Aimee N. C. Campbell, and Blair Beadnell. "Gender Differences in Heterosexual Anal Sex Practices Among Women and Men in Substance Abuse Treatment." AIDS and Behavior 17, no. 7 (January 16, 2013): 2450–58. http://dx.doi.org/10.1007/s10461-012-0387-7.

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Higgins, Jenny A., James Trussell, Nelwyn B. Moore, and J. Kenneth Davidson. "Young adult sexual health: current and prior sexual behaviours among non-Hispanic white US college students." Sexual Health 7, no. 1 (2010): 35. http://dx.doi.org/10.1071/sh09028.

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Background: Less is known about the sexual health of young adults than about adolescents, despite 20 to 24-year-olds’ greater risk of unintended pregnancy and sexually transmissible infections. This paper provides information on college students’ prior and current sexual practices including oral sex, vaginal intercourse, anal intercourse and masturbation. Methods: We analysed data from a cross-sectional sexuality survey of students from two university campuses in the USA, one Mid-western and one South-western (n = 1504). The sample consisted of non-Hispanic white, never-married students who identified as heterosexual. Results: Of 16 possible combinations of four sexual activities (solitary masturbation, oral sex, vaginal intercourse and anal intercourse), only four contained more than 5% of respondents: masturbation, oral sex and vaginal intercourse (37%); oral sex and vaginal intercourse only (20%); all four (14%); and none (8%). Twenty percent had ever engaged in anal intercourse. Women were significantly less likely than men to have ever masturbated (48 v. 92%). Analyses exhibited several sexual health challenges, including lack of verbal sexual consent, alcohol use proximal to sex and lack of contraceptive use. Conclusions: Although few young adults are substituting it for vaginal intercourse, anal intercourse is increasingly common and safer sex efforts should encourage condom use during both sexual activities. Masturbation should be encouraged as an alternative to higher risk sexual practices and an essential aspect of sexual well being. Finally, practitioners should continue to address specific threats to college students’ sexual health, including alcohol use and non-verbal consent.

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Blanc Molina, Andrea, and Antonio Rojas Tejada. "Comportamientos sexuales convencionales, en solitario, a través de las TIC y no convencionales en jóvenes heterosexuales = Conventional, solitary, via ICT, and unconventional sexual behaviors in heterosexual young people." REVISTA ESPAÑOLA DE COMUNICACIÓN EN SALUD 8, no. 2 (December 15, 2017): 207. http://dx.doi.org/10.20318/recs.2017.4001.

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Resumen: El objetivo del estudio es analizar diferentes tipos de comportamientos sexuales (CS; convencionales diádicos, en solitario, a través de las TIC y no convencionales) que los jóvenes refieren haber realizado o que podrían realizar, y comparar entre hombres y mujeres. Participaron un total de 886 jóvenes heterosexuales entre 18 y 30 años seleccionados mediante muestreo incidental y bola de nieve. Se les aplicó un cuestionario a través de internet que recogía información sobre CS convencionales diádicos, en solitario, a través de las TIC y no convencionales. Una mayor proporción de hombres que de mujeres realizan CS como la masturbación en solitario, fantasear sexualmente, el cibersexo y el trío. Las diferencias se incrementan (también en sexo anal y sexo en grupo) cuando la posibilidad de realizar los CS en un futuro es considerada. Las diferencias en los CS no convencionales y en el cibersexo podrían estar influidas por la doble moral sexual. Estudios recientes evidencian que la doble moral sexual podría estar desapareciendo en los CS convencionales, pero seguir presente en los CS menos convencionales.Palabras clave: comportamientos sexuales convencionales, comportamientos sexuales en solitario, comportamientos sexuales a través de las TIC, comportamientos sexuales no convencionales, jóvenes heterosexuales. Abstract: The aim of the study is to analyse different types of sexual behaviors (SB; conventional dyadic, solitary, via ICT, and unconventional SB) which young people report having performed or could perform, and to establish a comparison between women and men. A total of 886 heterosexual young people between 18 and 30 years selected by incidental and snowball sampling participated. A questionnaire via internet collecting information about conventional dyadic, solitary, via ICT, and unconventional SB was applied. A higher proportion of men than women perform SB such as solitary masturbation, sexual fantasies, cybersex, and threesome. The differences increase when the possibility of performing SB in the future is considered (also in anal sex and group sex). Unconventional SB and cybersex differences may be influenced by sexual double standards. Recent studies show that the sexual double standards may be disappearing for conventional SB, but may still be present for unconventional SB.Keywords: conventional sexual behaviors, solitary sexual behaviors, sexual behaviors via ICT, unconventional sexual behaviors, heterosexual young people.

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Duby, Zoe, Miriam Hartmann, Elizabeth T. Montgomery, Christopher J. Colvin, Barbara Mensch, and Ariane van der Straten. "Perceptions and Practice of Heterosexual Anal Sex amongst VOICE Participants in Uganda, Zimbabwe and South Africa." AIDS Research and Human Retroviruses 30, S1 (October 2014): A269. http://dx.doi.org/10.1089/aid.2014.5605.abstract.

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Reynolds, Grace L., Amanda D. Latimore, and Dennis G. Fisher. "Heterosexual Anal Sex Among Female Drug Users: U.S. National Compared to Local Long Beach, California Data." AIDS and Behavior 12, no. 5 (July 25, 2007): 796–805. http://dx.doi.org/10.1007/s10461-007-9271-2.

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Owen, Branwen Nia, Paddy M. Brock, Zara Shubber, Rebecca F. Baggaley, Ailsa R. Butler, Michael Pickles, Marc Brisson, Melanie Drolet, and Marie-Claude Boily. "31. Lifetime prevalence of anal intercourse among sexually active female youth and young female sex workers: a comparative systematic review and meta-analysis." Sexual Health 10, no. 6 (2013): 585. http://dx.doi.org/10.1071/shv10n6ab31.

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Background Anal cancer incidence has increased over the past twenty years. Heterosexual anal intercourse (AI) is a risk factor for HPV and HIV infection but is under-researched and ill-understood. We compare AI practices among young, sexually active general population females and female sex workers (FSW). Methods: We searched PubMed for heterosexual AI studies among young females, including FSWs (mean age <25 years), to December 2012. Study estimates were pooled using a random-effects model. Results: Fifty-four studies (42 average-risk, 6 higher-risk, 6 FSWs) were included. Most studies among general population youth were conducted in North America using self-administered questionnaires. All FSW studies were conducted in Africa and Asia using face-to-face interviews (FTFI). Pooled estimates of lifetime AI prevalence were larger among average-risk (23.6%, 95% CI 20.4–26.7) and higher-risk youth (25.5%, 95% CI 11.7–39.2) than FSWs (12.8%, 95% CI 8.4–17.3), but highly heterogeneous (I2 >90%). However, pooled AI estimates by continent of average-risk youth (Asia = 13.9%, 95% CI = 1.7–29.5; Africa = 18.4%, 95% CI 0.9–35.8) were more similar to those of FSWs (Asia = 16.0%, 95% CI 10.3–21.6; Africa = 9.7%, 95% CI 3.8–15.7). Estimates of average-risk youth reporting via FTFI (12.1%, 95% CI 0.7–23.5) were likewise similar to those among FSWs (12.8%, 95% CI 8.4–17.3). Pooled AI prevalence estimates among FSWs were higher in studies conducted after 2001 than in earlier studies. Conclusions: AI is common among sexually active females and may be increasing; it could therefore be an important determinant of HPV transmission and anal cancers. AI is as or more common among the general population youth than young FSWs but this may be confounded by continent, interview method and other unmeasured variables.

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Hollander, D. "Heterosexual Anal Sex Is Common Among STD Clinic Clients, but Is Frequently Not Protected by Condom Use." Perspectives on Sexual and Reproductive Health 41, no. 1 (March 2009): 66. http://dx.doi.org/10.1363/4106609.

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Leichliter, Jami S., Anjani Chandra, Nicole Liddon, Kevin A. Fenton, and Sevgi O. Aral. "Prevalence and Correlates of Heterosexual Anal and Oral Sex in Adolescents and Adults in the United States." Journal of Infectious Diseases 196, no. 12 (December 15, 2007): 1852–59. http://dx.doi.org/10.1086/522867.

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Drago, Francesco, Astrid Herzum, Giulia Ciccarese, and Roberto Bandelloni. "Prevalence of oral human papillomavirus in men attending an Italian sexual health clinic." Sexual Health 13, no. 6 (2016): 597. http://dx.doi.org/10.1071/sh16155.

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A high-risk population, formed by 79 consecutive male attendees of our sexually transmissible infections clinic, and who did not have any overt signs of human papillomavirus (HPV) infection, were examined. Oral HPV prevalence (37%) was much higher than previously reported. Periurethral HPV-DNA was found in 49% of the patients and anal HPV-DNA was found in 43% of the patients. Considering the high prevalence of oral HPV obtained in the current study, it is important to further investigate the burden of oral HPV, not only in men who have sex with men, but also in heterosexual men and in women.

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Lim, Megan S. C., Jane L. Goller, Rebecca Guy, Judy Gold, Mark Stoove, Jane S. Hocking, Christopher K. Fairley, et al. "Correlates of Chlamydia trachomatis infection in a primary care sentinel surveillance network." Sexual Health 9, no. 3 (2012): 247. http://dx.doi.org/10.1071/sh11019.

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Background Chlamydia is the most commonly notified infection in Australia. Prevention strategies should be informed by routine data on at-risk populations. Methods: We calculated chlamydia positivity and correlates of infection using multivariable logistic regression for data collected between April 2006 and June 2009. Results: Chlamydia positivity was 5.6% in 12 233 females, 7.7% in 10 316 heterosexual males and 6.2% in 7872 men who have sex with men (MSM). Correlates of chlamydia positivity among females included younger age (odds ratio (OR) 2.27, 95% confidence interval (CI) 1.92–2.69), being born overseas (OR 1.50, 95% CI 1.25–1.82), multiple sex partners in the past year (OR 1.72, 95% CI 1.40–2.11) and inconsistent condom use with regular sex partners (OR 3.44 ,95% CI 1.65–7.20). Sex work was protective for females (OR 0.68, 95% CI 0.53–0.86). Among heterosexual males, correlates of positivity were younger age (OR 1.87, 95% CI 1.62–2.17), being born overseas (OR 1.35, 95% CI 1.16–1.58), symptoms at the time of testing (OR 1.64, 95% CI 1.40–1.92) and multiple sex partners in the past year (OR 1.83, 95% CI 1.46–2.30). Correlates of positivity among MSM were being born overseas (OR 1.23, 95% CI 1.00–1.51), being HIV-positive (OR 1.80, 95%CI 1.32–2.47), and reporting six or more anal sex partners in the past 6 months (OR 4.45, 95% CI 1.37–14.5). Conclusions: Our analysis identified subgroups at the highest risk of chlamydia in Victoria. These estimates will provide important baseline information to measure the impact of chlamydia control strategies.

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Smelov, Vitaly, Miriam Elfström, Carina Eklund, Olga Sokolova, Andrey Novikov, Boris Komyakov, and Joakim Dillner. "43. Anal human papillomavirus prevalence in HIV-negative and HIV-infected Russian men who have sex with women." Sexual Health 10, no. 6 (2013): 591. http://dx.doi.org/10.1071/shv10n6ab43.

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Background HPV has been found in the anal canal of heterosexual men (MSWs) but knowledge on anal HPV epidemiology among MSWs is still limited. So far, there are no such data from Russia. Methods: In total, 350 β-globin-positive anal samples from Russian MSWs (age 18–58 years; sex debut 9–23 years; 1–700 life-time sex partners) attending a urology unit of an STI clinic and HIV+ patients from a city infection hospital were collected in St Petersburg. PCR using HPV general primers with genotyping using Luminex with probes for 13 oncogenic, high-risk HPV types (16, 18, 31, 33, 35 39, 45, 51, 52, 56, 58, 59, and 68, including variants) and 23 non-oncogenic types (6, 11, 26, 30, 40, 42, 43, 53, 54, 61, 66, 67, 70, 73, 74, 81, 82, 83, 86, 87, 89, 90, and 91) was used with 11 negative controls (water) and 8 positive controls (HPV plasmid pools) run in each assay. The method was proficient in the WHO HPV LabNet global proficiency panel. Results: Overall, HPV prevalence (including oncogenic and non-oncogenic types) was 17.1%, with 15.2% in HIV– compared with 40.7% in HIV+ Russian MSW (P = 0.0022). The most commonly detected was HPV-16 (5.4%) followed by HPV-51 (2.0%), HPV-45, (1.7%) and HPV-87 (1.7%). Interestingly, neither age, nor number of sexual partners, nor age at sexual debut were associated with HPV infection. Conclusions: HPV infection is common in anal canal samples of Russian MSWs. HPV prevalence is higher among men who were HIV positive.

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Gaisa, Michael, Keith Sigel, Jonathan Hand, and Stephen Goldstone. "High rates of anal dysplasia in HIV-infected men who have sex with men, women, and heterosexual men." AIDS 28, no. 2 (January 2014): 215–22. http://dx.doi.org/10.1097/qad.0000000000000062.

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Audu, O., GO Ogbeyi, VN Omole, IA Joshua, AA Gobir, and JA Anejo-Okopi. "Assessment of Sexual Risk Behaviours among Young People Patronizing Alcoholic Beverage Selling Outlets in Makurdi, Benue State, Nigeria." Journal of Epidemiological Society of Nigeria 3, no. 2 (December 2, 2020): 37–45. http://dx.doi.org/10.46912/jeson.36.

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Background: Young people constitute 16% of the global population and in Benue State Nigeria, majority of them take alcohol which is one of the identified drivers of high risk sexual behaviours. However, intervention strategies at the pubs where alcoholic beverages are sold remain peripheral. This study assessed the sexual risk taking behaviours among young people who patronized alcoholic beverage selling outlets in Makurdi, the Benue State capital.Methods: A community based cross-sectional study using interviewer administered questionnaire was conducted among 273 young people sampled from 4 night clubs and 28 bars. Logistic regression analysis was conducted to determine the relationship between alcohol use and risky sexual practices with statistical significance set at p =0.05Results: Seventy-four percent of the respondents had history of sexual intercourse with mean age of 18.2 (±3.0) years at sexual debut. Ninety eight (48.5%) had sexual intercourse within a week prior to the study, 73.8% took alcohol before the last sexual intercourse and the practice corroborates a cycle of sexual risk behaviour which include: heterosexual (100%), one-night stand (62.2%), sex without condoms (48.0%), oral sex (42.6%), sex in exchange for money (32.7%), anal sex (26.5%) and group sex (9.2%). Those who take alcohol are 8.5 times at higher risk of engaging in anal sex {(OR- 8.464) (95% CI = 2.919 – 24.53) (p= 0.0433)}.Conclusion: Policymakers working on risk taking behaviour intervention should consider night clubs and other drinking establishments in order to mitigate the effects of diseases transmitted through high risk sexual behavior among young people.

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Johns, Michelle Marie, Emily Pingel, Anna Eisenberg, Matthew Leslie Santana, and José Bauermeister. "Butch Tops and Femme Bottoms? Sexual Positioning, Sexual Decision Making, and Gender Roles Among Young Gay Men." American Journal of Men's Health 6, no. 6 (July 27, 2012): 505–18. http://dx.doi.org/10.1177/1557988312455214.

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Gender and power are theoretical constructs linked to discussions of sexual transmission of HIV/AIDS among heterosexual couples. Despite the fact that HIV rates are rising among young men who have sex with men in the United States, work examining the role of gender in sexual decision making of young men who have sex with men remains in its infancy. Through qualitative interviews with 34 young gay men (YGM), the authors seek to contribute to the literature in this area by focusing on the ways that YGM understand and enact sexual positions during anal sex. The authors’ results highlight the diversity of YGM’s sexual preferences, as well as the high degree of sexual fluidity. Ideas of gender appear to inform part of this process; however, YGM critiqued conventional gender norms and emphasized the centrality of relationships (i.e., casual vs. romantic) in their sexual decision making. The authors discuss the importance of considering gender and interpersonal factors when designing HIV/AIDS prevention messages for YGM.

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Mueses Marín, Héctor Fabio, Inés Constanza Tello Bolívar, María Isabel Galindo Orrego, and Jaime Galindo Quintero. "Perceptions about sexual risk, HIV and HIV-testing in Cali, Colombia." Colombia Médica 49, no. 2 (June 1, 2018): 139–47. http://dx.doi.org/10.25100/cm.v49i2.2945.

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Introduction: In Colombia, 20%-54% of the population with sexual practices at higher risk for HIV infection (men who have sex with men, transgender women, women sex workers) has sometime been tested. Objective: To describe perceptions of sexual risk, HIV and HIV testing in people with risky sexual practices and people who identify themselves as heterosexual. Methods: Between 2012 and 2014, it was carried a descriptive study using HIV screening out in Cali-Colombia with the voluntary participation of 940 people aged over 18 years. There were used: informed consent, structured questionnaire and HIV testing. Descriptive, bivariate and multivariate Poisson regression models were performed. Results: Average age 28.5 ±10.9 years; 50% men. 357 (38%) were people from the traditional risk group for HIV infection; and 583 (62%) corresponded to the non-traditional risk group (heterosexual men and women). Likewise, 62% and 41% respectively had HIV test. 51% to 53% reported having sex when they consumed liquor; commercial sex was higher in the group with risky sexual practices (32% vs 3%), as well as anal relations (77% vs 23%), consistent use of condom (32% vs 9%), and HIV positive test (14.3% vs 1.6%). The multivariate analysis showed for both groups that having HIV test was associated with being older than 25 years and a history of sexually transmitted infection. Conclusions: Differentiated education strategies are needed based on risky sexual behaviors and that consider the importance of regular HIV tests for early diagnosis and timely enrollment in care and treatment.

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Dolan, Kate, David Lowe, and James Shearer. "Evaluation of the Condom Distribution Program in New South Wales Prisons, Australia." Journal of Law, Medicine & Ethics 32, no. 1 (2004): 124–28. http://dx.doi.org/10.1111/j.1748-720x.2004.tb00457.x.

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Male to male unprotected anal sex is the main route of HIV transmission in Australia. The Australian Study of Health and Relationships, a large, representative population survey of sexual health behaviors, found that six percent of males in the general population have engaged in homosexual activity. These findings were consistent with studies in Europeand North America. Condoms have been shown to reduce the transmission of HIV in the community. Barriers to the use of condoms include access,stigma,and cost? Nevertheless, increased condom use has been reported among homosexual males, sex workers and injecting drug users although recent declines in condom use among homosexuals has presented new challenges in HIV prevention.The prevalence of male to male sexual activity may be higher in prison than in the general population. Sexual activity in prison can be consensual and non-consensual involving both homosexual / bisexual and heterosexual men.

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Journal articles on the topic 'Heterosexual Anal Sex'

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