Heterosexual anal intercourse (HAI) is common among U.S.
women. Receptive anal intercourse is a known risk factor for HIV, yet there is
a paucity of data on HAI frequency and distribution in the United States.
Condom use is lower with HAI vs. vaginal intercourse, but little is known
regarding of correlates of HAI with and without condoms.
The aims of this study were to describe recent (past 12
months) and lifetime HAI among sexually active reproductive-aged U.S. women,
and to characterize women who engage in HAI with and without condoms.
We analyzed a sample of 10,463 heterosexually active women
aged 15-44 years for whom anal intercourse data were available in the 2006-2010
National Survey of Family Growth.
Weighted bivariate and multivariable analyses were used to determine
HAI prevalence and correlates. Primary outcomes were lifetime HAI, recent (last
12 months) HAI, and condom use at last HAI.
In our sample, 13.2% of women had engaged in recent HAI and
36.3% in lifetime HAI. Women of all racial and ethnic backgrounds and religions
reported recent anal intercourse. Condom use was more common at last vaginal
intercourse than at last anal intercourse (28% vs. 16.4%, P < 0.001). In
multivariable analysis, correlates of recent HAI included: less frequent church
attendance, younger age at first intercourse, multiple sexual partners, history
of oral intercourse, history of unintended pregnancy, and treatment for
sexually transmitted infections (all P < 0.05). Correlates of lifetime HAI
were similar, with the addition of older age, higher education, higher income,
and history of drug use (all P < 0.05).
Women of all ages and ethnicities engage in HAI, at rates
higher than providers might realize. Condom use is significantly lower for HAI
vs. vaginal intercourse, putting these women at risk for acquisition of
sexually transmitted infections.
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By:
- 1Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
- 2Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, University of Chicago, Chicago, IL, USA.
- 3Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
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