Little is known about painful
receptive anal intercourse (RAI) and its relationship to HIV risk and protective
behaviors among men who have sex with men (MSM). The purpose of this study was
to identify attributions for and responses to painful RAI among Black MSM in
South African townships. In-depth interviews were conducted with 81 Black MSM
(ages 20-39 years) who were purposively recruited from four townships. The
semi-structured interviews addressed sexual behavior and identity, alcohol use,
and safer sex.
Pain during RAI was brought up by many participants without
specific prompting from the interviewer. Analysis of the interview transcripts
revealed that pain was a common feature of first RAI experiences but was not
limited to first-time experiences. The participants attributed pain during RAI
to partner characteristics, interpersonal dynamics, lack of lubricant, and
alcohol use or non-use. The main strategies participants used to address pain
during RAI were setting sexual boundaries and lubricant use; a small number of
participants reported purposefully consuming alcohol to prevent the pain
associated with RAI.
Black South African MSM can be supported to reduce pain
during RAI in ways that reduce their HIV/STI risk. Culturally specific sexual
health education, supportive sexual health services, and improved access to
condom-compatible lubricants are important components of HIV/STI interventions
for this population.
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By:
- 1Division of Gender, Sexuality, & Health and HIV Center for Clinical and Behavioral Studies,, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
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