Underreported Anal Sex in Women

Grace Reynolds
California State University, Long Beach Foundation
Social and Behavioral Sciences

HIV infectivity during anal sex is more efficient than vaginal transmission yet heterosexual receptive anal intercourse (HRAI) in women is poorly understood.  The practice of HRAI occurs within different contexts and alcohol and drugs may have mediating effects on HRAI.  Previous research indicates that anywhere from 8 percent to 39 percent of heterosexuals reported HRAI in the past year.  However, research is lacking on the HIV risks associated with frequent acts of HRAI among heterosexual women, as well as the epidemiology of predictors of HRAI.  One study of clients of sexually transmitted disease clinics noted that proportions of individuals reporting HRAI appear to be increasing over time.  Predictors of frequent receptive anal intercourse in men who have sex with men are fairly well researched, but the same cannot be said for women.  This proposed research attempts to assess women’s understandings of anal sex using qualitative methods; and to use electronic diaries using smart telephones to gather event level data on occurrences of anal sex in two, non-equivalent groups: drug-using women who have previously reported receptive anal sex with a male partner, and drug-using women who have not previously reported receptive anal sex.  Women will be recruited from an existing database of current clients of the Center for Behavioral Research and Services (CBRS) of women who have previously unprotected anal sex.  A small number of key-informant women will be invited to participate in focus groups and unstructured interviews concerning their understanding of receptive anal sex.  Data from these focus groups and unstructured interviews will inform the questions deployed via smart telephone for a sexual-event diary study.  Diary information will be collected longitudinally for 12-weeks following procedures developed by Fortenberry, et al.