Anal Intercourse Among Young Heterosexuals in Three Sexually Transmitted Disease Clinics in the United States

The researchers designed the current study to examine factors associated with heterosexual anal intercourse (AI).

Data were collected between 2001 and 2004. At public STD clinics in Seattle, New Orleans, and St. Louis, 1,084 heterosexuals ages 18 to 26 underwent computer-assisted self-interviews and were tested for these STDs: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, and genital herpes (HSV-2). Logistic regression was used to identify characteristics associated with AI.

Of the subjects, 400 (37 percent) reported ever having had AI; 266 (28.9 percent) reported AI with at least one of their last three partners; 19 percent reported AI with their last partner. Fewer women than men (26 percent vs. 45 percent, P<0.001) reported condom use at last AI. Ever having had AI was associated with sex on the same day as meeting a partner [AOR 3.9 (95 percent CI, 2.46-6.21)], receiving money for sex [AOR 2.8 (1.40-5.45)], and more than three lifetime sex partners [AOR 2.8 (1.56-5.07)] among women. Among men, ever having AI was associated with sex on the same day as meeting a partner [AOR 2.0 (1.33-3.06)].

AI with last partner was associated with sex toy use [AOR 5.6 (2.63-12.0)] and having concurrent partners [AOR 2.2 (1.21-4.11)] among men. Among women, AI with last partner was associated with sex within a week of meeting [AOR 2.4 (1.28-4.37)], believing the partner was concurrent [AOR 1.9 (1.12-3.22)], and sex toy use [AOR 5.7 (2.31-14.0)]. Prevalent vaginal and urethral sexually transmitted infections were not associated with AI.

"Many young heterosexuals attending [STD] clinics reported AI, which was associated with other sexual risk behaviors, suggesting a confluence of risks of HIV infection," the authors concluded.

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