Why Women Engage in Anal Intercourse: Results from a Qualitative Study

This report used qualitative methods to assess why women engage in heterosexual anal ( centripetal ) sexual intercourse ( AI ) with a male spouse. Four focus groups which comprised women from diverse ethnicities were conducted. All groups were digitally recorded for transcription ; transcripts were analyzed using the methods of ground theory to determine themes. Women ’ s reasons for engaging in anal intercourse with a male partner can be described in wide categories including that the women wanted to have anal intercourse, either because of their own desire, to please a male partner, or they were responding to a chew pro quo situation. The riskiness of AI was assessed within kinship context. past feel with AI including aroused and physical reactions was identified. Among the negative physical experiences of AI were pain and disliking the sensation, and uncomfortable side effects, such as run of the rectum. negative aroused experiences of AI included feelings of shame, disgust, and being offended by something her male partner did, such as spitting on his penis for lubrication. positive physical experiences included liking the sensation. Many of the women besides endorsed cocksure aroused experiences of AI, including that it was more intimate than vaginal sex, and that it was something they reserved only for special partners. The majority of AI episodes were unintentional and not discussed anterior to trigger. pain during AI was mitigated by the use of lubricants or illegitimate drugs. even those women who found pleasure in AI expressed a preference for vaginal sexual intercourse. The current discipline sought to examine why heterosexual women engage in anal intercourse. Due to the limited nature of previous inquiry on this topic, we opted for a more exploratory approach aimed at uncovering the broad scope of reasons that women had for engaging in anal intercourse. anal intercourse in this discipline refers to the penetration of a womanhood ’ sulfur anus by her partner ’ mho penis, and not the more general category of sexual behaviors, anal sex, which can include anal-oral contact and digital penetration. To enhance the relevance of this work for both the mental health and populace health sectors, we besides sought to examine women ’ second perception of gamble related to anal sexual intercourse and women ’ second emotional and physical experiences during the run into itself. Gender and ability theory, which focuses on the sexual division of tug, sexual division of power, and sociable norms associated with relationships between men and women, may besides inform our understanding of heterosexual anal sexual intercourse ( Connell, 1987 ). Wingood and DiClemente ( 2000 ) extended Connell ’ mho theory into populace health to include behavioral and biological hazard factors as explanations for women ’ sulfur increased gamble for HIV. Their model includes alcohol and drug practice and bad firm partners who have been linked to anal intercourse. DePadilla, Windle, Wingood, Cooper, and DiClemente ( 2011 ) validated Wingood and DiClemente ’ s model with empirical data demonstrating the relationship between theoretical constructs of gender and baron and condom use. Pulerwitz, Amaro, De Jong, Gortmaker, and Rudd ( 2002 ) found that the construct of sexual kinship power accounted for variation in the use of condoms for vaginal sexual activity among Latina women, with greater perceived relationship power being associated with more condom use ; their findings on the importance of relationship power were replicated in a study of anal sexual intercourse in minority female adolescents, where greater relationship office was associated with the ability to refuse anal sexual intercourse with a male collaborator ( Roye, Tolman, & Snowden, 2013 ). Gender stereotypes provide behavioral norms for a kind of social settings ; in intimate situations, men and women may be compelled to follow behavioral expectations ( Deaux & Lewis, 1984 ; Sanchez, Crocker, & Boike, 2005 ). Research has demonstrated that individuals may rely on these behavioral norms and sex stereotypes when engaging in sexual activity with a fresh partner ( Littleton & Axsom, 2003 ). Through these traditional gender roles and sexual scripts ( for example, sex and role conventions ), women have been taught to prioritize their partners ’ needs above their own, and this may be a hard incentive for women engaging in anal intercourse when the male partner desires it.

Social cognitive theory ( Bandura, 1986 ) may help explain women ’ s decisions to have anal intercourse. Bandura stated that human behavior is learned from watching and interacting with other homo beings. Women may learn about anal intercourse through male sexual activity partners, and then they may suggest anal intercourse with new sex partners for a variety show of reasons, including a hope to be reactive to his desires or because she has learned to like anal intercourse from the feel with a former sex partner. While this growing body of literature suggests that anal intercourse among heterosexual women may be more prevailing than previously assumed ( particularly among drug-abusing samples of women ), there is presently very little information about why these women are engaging in anal intercourse. While some have suggested that images of sexual demeanor found in popular media may influence both men and women ’ sulfur intimate behavior ( Peterson & Hyde, 2010 ), the extent to which media images play a function in women ’ south decisions to engage in anal intercourse ( or men ’ s requests for anal sexual intercourse ) is unclear. similarly, while others have suggested that women ’ second decisions to engage in anal sexual intercourse may be nested within complex sex relationships that privilege male pleasure and female subjugation ( Hekma, 2008 ; Peterson & Hyde, 2010 ), the extent to which women reference traditional gender roles ( for example, men are concern in sexual activity as conquests, while women are passive voice recipients of male advances ) and sexual scripts ( for example, shared conventions about gender roles during intimate natural process ) when deciding to engage in anal sexual intercourse remains indecipherable ( Dworkin, Beckford, & Ehrhardt, 2007 ; Simon & Gagnon, 1986 ). There is besides research literature on heterosexual anal intercourse among drug-using subsamples, which has found a relationship between anal intercourse and both injection and non-injection drug use ( Bogart et al., 2005 ; Lorvick, Martinez, Gee, & Kral, 2006 ; Powis, Griffiths, Gossup, & Strang, 1995 ; Risser, Padget, Wolverton, & Risser, 2009 ; Strang, Powis, Griffiths, & Gossup, 1994 ; Zule, Costenbader, Meyer, & Wechsberg, 2007 ), angstrom well as use of prescription drug drugs and PD5 inhibitors such as Viagra ( Fisher et al., 2006 ). Mackesy-Amiti et aluminum. ( 2010 ) found that among drug-using women, anal arouse was more likely to occur during transactional sex ( sex for drugs or money ) and was not associated with emotional closeness. interest in anal sexual intercourse has besides come from research in homo immunodeficiency virus ( HIV ) transmission. several studies have quantified the increased hazard of heterosexual transmission from one act of anal sexual intercourse as compared to one act of vaginal intercourse ( Boily et al., 2009 ; Leynaert, Downs, & de Vincenzi, 1998 ; Powers, Poole, Pettifor, & Cohen, 2008 ). The increase gamble of HIV transmission through anal intercourse has been well documented in studies of homosexual and bisexual men ; however, there has merely recently been sake in documenting comparable risks among heterosexual samples. The studies that have used heterosexual samples have generally focused on parts of the universe, such as South Africa, that have not merely high rates of anal intercourse among heterosexuals, but besides high HIV prevalence in the general population and senior high school numbers of coincident partners among heterosexuals ( Kalichman et al., 2011 ; Thomas, 2009 ). Partner concurrence and the higher transmissibility of HIV through anal sexual intercourse besides make studying heterosexual anal sexual intercourse compelling in the United States where the prevalence of HIV is high chiefly in cultural minority samples, such as african American and Latina women who have sex with men ( McLellan-Lemal et al., 2012 ; Neblett & Davey-Rothwell, 2011 ; Reynolds, Fisher, & Napper, 2010 ). According to the U.S. Centers for Disease Control and Prevention ( CDC, 2013 ), 86 % of HIV cases in women are attributable to heterosexual contact : 65 % of HIV infections in african american women and 17 % of HIV infections in Latina women are attributable to heterosexual contact. research with women who have male partners recently released from jail or prison has besides yielded high rates of anal sexual intercourse ( Bland et al., 2012 ; Swartzendruber, Brown, Sales, Murray, & DiClemente, 2011 ). Harawa and Adimora ( 2008 ) linked high captivity rates among both men and women in the african American residential district with HIV through a number of mechanisms, including the character captivity plays in reducing the number of male sexual partners available to african american english women. late pastime in heterosexual anal intercourse has been generated from respective research perspectives. In the United States, general population surveys have suggested that the prevalence of anal intercourse among heterosexuals has increased over time ( Leichliter, 2008 ). It is not possible to know from these surveys whether the prevalence of anal intercourse is actually increasing, or as some would suggest that the sexual repertory of Americans has expanded to include anal sexual intercourse, along with oral and vaginal sex ( Leichliter, 2008 ; McBride & Fortenberry, 2010 ). There may nowadays be less mark attached to anal sexual intercourse, and respondents to these general population surveys may be more comfortable admitting to the behavior ( Mosher, Chandra, & Jones, 2005 ). presently in the United States, there are no states that have laws criminalizing anal intercourse ( Kelvin, Smith, Mantell, & Stein, 2009 ). The increase in the report of anal sexual intercourse among heterosexuals has implications for public health efforts to educate individuals about the risks of sexually transmitted infections, including those that may be transmitted through anal touch ( Fleming & Wasserheit, 1999 ; Gorbach et al., 2009 ; Gross et al., 2000 ; Halperin, 1999 ; Javanbakht et al., 2010 ; Tian et al., 2008 ). The audio files produced by the recording equipment in MP3 format were transcribed direct and imported into Dedoose, an on-line qualitative analysis program that facilitates coding, sorting, and displaying mix method data. specific analysis procedures followed many of the recommendations of Grounded Theory ( Glaser, 1998 ; Miles & Huberman, 1994 ) and unfolded in several phases. In the foremost phase, the second writer read over the transcripts and noted key ideas in the margins ( a step known as bare code ) ( Miles & Huberman, 1994 ). In the second phase, a constant comparison method was used to group and organize the fringy codes conceptually. This inductive process resulted in a hierarchically organized codebook containing codes and subcodes that emerged from the data itself. In the one-third phase, Dedoose was used to mark excerpts from the transcripts. Excerpts were identified both conceptually ( based on the begin and ending of a distinct idea ) and contextually ( including all necessity information for accurate interpretation ). The codebook was then upload to Dedoose and used to assign applicable codes to the excerpts. Dedoose was used to assess inter-rater dependability utilizing a random selection of one-third of the excerpts created by the moment writer. In most cases, disagreements involved omissions. This occurred when one person applied a code that was overlooked by the other person. When these omissions were counted as disagreements, the kappa coefficient was .79. When these omissions were left out of the calculations, kappa increased to .93, indicating that there were few outright disagreements in coding. All omissions and discrepancies were then discussed by the coders, and a consensus approach was used to assign concluding codes. Each of these codes and sample quotes are described in detail below. Women then answered a brief demographic questionnaire that elicited information on their age, self-reported ethnicity, and the numeral of biological children, whether they had had oral, vaginal, and anal sexual intercourse at any item in their life, and whether their last intimate run into was with a man or a woman. The demographic questionnaire was followed by a description of concentrate group procedures and footing rules. Following the recommendations of Krueger ( 1994 ), the concentrate group protocol consisted of five by and large worded questions about heterosexual anal sexual intercourse with male partners, how often it had occurred in their life, the frequency of anal sexual intercourse with their current or most late intimate partner, the context in which the anal sexual intercourse event took place ( type of collaborator, such as new, casual, and regular ), the function of alcohol and illicit substances in facilitating the anal sexual intercourse, and other relevant characteristics of the male partners ( known to be bisexual, previous captivity history ) and any early information the women were bequeath to provide concerning the anal intercourse event itself ( for example, lubricants or enema used, placement such as a motel ). Participants were allowed to respond ad lib to each motion and were not required to seek license to speak or speak in a indicate regulate. Although each participant was not required to answer each question, the facilitator did encourage participation from all women and made efforts to elicit diverging perspectives. Upon arrival at the focus group location, participants were beginning informed about the nature of the study and all associated risks and benefits. Informed accept was a two-stage process : women consented first to participate in the focus group and signed an inform consent shape approved by the CSULB Institutional Review Board. The second degree consent summons required the women to give classify accept to have the concenter group digitally recorded for later arrangement and cryptography. entirely women who were volition to consent at both stages, that is, to participate in the focus group and to allow the group to be recorded, participated in the concluding focus groups. none of the women refused to be audio taped. Women who met the screening criteria described above were invited to participate through a verbal invitation, a fly, and/or a letter, and were offered $ 50 cash as an incentive. Each stress group was scheduled on a different day and time to maximize engagement, but all focus groups were conducted at both the community-based drug treatment and the HIV/STI testing center from which the women had been recruited. Following the recommendations of Krueger ( 1994 ), each focus group consisted of 7–10 participants, and all focus groups were conducted by the first author who has experience with group facilitation and has worked extensively with the population served at both the drug treatment center and CBRS. The focus groups were constituted indeed that all the women in each group were of the lapp ethnicity ; group 1 was african American, group 2 was Latina, and group 3 was White, but group 4 was blend with approximately adequate proportions of african American and White women. A full of 32 women participated in four separate focus groups about heterosexual women ’ randomness experiences with anal intercourse. All participants were recruited through an outpatient drug treatment plan and a community-based HIV and sexually impart infections ( STI ) testing plan ; the testing program was located at the Center for Behavioral Research and Services ( CBRS ), an organized research center of the California State University, Long Beach ( CSULB ). Women were invited to participate in the focus groups if they were at least 18 years of age and acknowledged having had anal intercourse with a valet during a previous interview at CBRS and had by experience of illicit drug manipulation. The majority had participated in some form of outpatient drug discussion, but some of the women had never received formal treatment for their drug consumption. All of the women answered “ Yes ” to the question “ Have you always in your life had receptive anal sex ( your collaborator ’ second penis in your butt/anus ) ” during the initial riddle procedures, but only 73 % reported having receptive penile-anal sexual intercourse on the brief questionnaire administered immediately anterior to the focus groups. Further questioning revealed that all of the participants had had anal sexual intercourse, but some did not count it as such if the man did not ejaculate or if the womanhood insisted he withdraw because of annoyance. Focus group methods were selected to uncover the wide range of reasons that drug-abusing women may have for engaging in heterosexual anal intercourse. Focus groups are particularly well suited for uncovering a full crop of opinions, experiences, or concerns about a topic ( Krueger, 1994 ). Given the specify nature of data on this subject, we thought that the types of generative discussions that take station during focus groups would yield the widest range of experiences, opinions, and insight into women ’ sulfur reasons for and experiences of engaging in anal intercourse. Focus groups were besides preferred by the participate outpatient drug treatment program because participants were familiar with group activities and settings. They don ’ thymine know what they are doing. They fair want to do it without…they push you all hard rather of going soft…They are focused on themselves and what they want and not, not realizing that it will hurt us more than them. ( african American, Group 4 ) The anal arouse for me is comparable hard. Because the one time that I did do it, I was intoxicated and it was fucking shoved in and it hurt. And I was like, it was all bad. ( Latina, Group 3 ) While some of the women merely expressed discomfort or antipathy for anal intercourse, others described specific circumstances that contributed to their dislike of anal intercourse. For example, five of the women ( 5/32 ; 15.6 % of participants ) described male partners who were then focused on their own joy that they failed to consider the women ’ south experiences : My have was like, american samoa soon as this asshole got done fucking me in the fuck, I had to go to the toilet. then, when I took a shit, I wiped my shit and there was blood on the fuck matter. indeed, yeah, that ’ s not a beneficial thing to be fucked in the american samoa. It ’ s very not. For veridical, for real, my saying to this day is exit only. You know what I ’ megabyte saying ? Like it ’ s made for crap to come out not to go in. ( african American, Group 1 ) I thought that at the time something pluck, I don ’ metric ton know. Yeah, it was very afflictive. Like, for the first copulate of times I tried it, like it felt, seriously it felt like, this is what I thought : I was like, “ is my butthole turned inside out ? ” You know what I mean ? It was like it barely hurt. It was very, very atrocious. ( african American, Group 1 ) I ’ m going to put it like this : Hold up, hold up. If you are with a guy who knows what he is doing, it won ’ triiodothyronine hurt that bad if he takes his time and stuff…it ’ randomness actually not that bad if the person knows what he is doing. If he is taking his time and stuff and lubricate, then it ’ s all correctly. ( african American, Group 1 ) It was besides clear that specific context or circumstances were typically required in order for the women to enjoy the have. For case, seven of the women ( 7/32 ; 22 % of participants ) emphasized the importance of male experience with the use of lubricants for a woman ’ s enjoyment : Catch me on my come down. On my come down, it was like, I don ’ thymine know what it is, I love sex when I ’ thousand coming down. When I ’ molarity coming down, sleep together. I love to fuck on my come down. That is like the best sex ever. I don ’ t know what it is about it…It ’ randomness like you ’ re half asleep, half wake up, like, it ’ s the best. ( Latina, Group 2 ) Like, he is my child ’ randomness dad….It ’ sulfur good that that was the lone man I knew I could come and have sexual activity with rather of going to be a ho-bag at the time. But I mean, I kept on going back to him, running back to him, running back to him. And then, ultimately, when I realized he had a boyfriend and everybody was telling me the truth, and then he told me, I was like, fellow, why didn ’ triiodothyronine you tell me ? You know, like the times we ’ ve had sex, I ’ meter transfer, getting AIDS. You could have made me aware. ( african American, Group 1 ) My first time was with my boyfriend who turned out to be my husband. We were dating and my first time was with him. At the clock time, I didn ’ thyroxine think it was hazardous. I trusted him. ( african American, Group 1 ) In my disgusted head, in my pale addiction, I ’ m like, oh, fuck it, it is what it is. That ’ s how I take things, particularly with HIV, my brother has it. I take it, like, if I get it, I get it. I ’ ve injected needles with other people…I ’ ve done so much stool that like, it ’ s like a cold to me now. If I get that cold, I get it, and I suffer the consequences. ( african American, Group 1 ) Six of the women ( 6/32 ; 19 % of participants ) described an absence of refer about risks associated with anal intercourse, at least at the time the women were engaging in the act and described three main factors that contributed to a miss of refer about risk : being on drugs, trusting their partner, and being in the heat of the consequence. Five of the women ( 5/32 ; 15.6 % participants ) described their substance use as interfering with their concerns about gamble or willing to engage in condom sex practices. I know from my personal feel, um, the final person that I was with, um, well, I had anal sex with him. And I had like lots of sex with him. But it was all under the charm. And, um, I ’ ve heard since then that hedlx is, um, bisexual. So I had an HIV trial when I came back here, and, um, was kind of worry about it. But I ’ megabyte o. But, um, I put myself at risk with him, cause, uh, I found out that he has had like multiple partners of both sexes. ( african American, Group 1 ) The end one that I was with that I found out had been messing around with other men… I thank God that I never caught anything from him. cause I was at the most gamble of catching HIV ever most in my life sentence with him. ( Latina, Group 2 ) That ’ s another thing with using the Saran Wrap or a formative udder or whatever. It ’ s like that shit is not gon na protect you like a condom…the thing I ’ meter trying to say is if you are using the wrong contraceptive, that bullshit is gon na go through that. You feel me ? Because it is not proper. That ’ s not the proper manner to perform. ( White, Group 3 ) Women described two main factors that contributed to their sensing of risk : miss of protection ( e.g., condoms ) and partner ’ s sexual history. Five of the women ( 5/32 ; 16 % of participants ) focused on the lack of protection that resulted from not using a condom, using a inadequate substitute for a condom or using the wrong type of lubricant that could damage the condom : It is hazardous and I think it is because they be so agitate that you have to slow them down…you have to slow them down and let them know, hey, you know, this is a fiddling piece different. It is hazardous. It is very hazardous. ( african American, Group 4 ) Although the majority of participants said that they did not engage in anal sexual intercourse as a form of birth control, three participants ( 3/32 ; 9 % ) said that they had engaged in anal sexual intercourse in orderliness to avoid vaginal sex when they were on their time period :

We were doing regular sex and then he ask me for my loot. I know he has been to prison, he just got out of prison, and I ’ m like, nah, don ’ metric ton do that. And he said, well, let me give you a massage. And I was like, yeah, I got sensitive leg. Go ahead and give me a massage. He put lotion on my legs and massaged them on up and up my thighs. And he got to the loot and massaged it. then the next matter you know–BAM ! –there he go ! He went on and hit it. I was like, no, don ’ triiodothyronine do that. then he was actual legato with it. I said, oh, this asshole has experience with this thing. ( african American, Group 1 ) You ever had the kind that while you were having sexual activity it slipped out…and alternatively of going boom second in the coochie, they go true for the fuck, knowing that own ’ t the coochie ? No, no, my coochie way up here ! My bullshit direction up here ! [ Do you think he was measuredly trying to deceive you or was he just confused and in the moment ? ] He was confused my ass ! All the lights were on ! Nigga, you see this ! I got a hairy coochie ! Ain ’ t no hair’s-breadth around my asshole. He wanted some fuck ! Yeah, they know what they ’ rhenium doing. They ’ re trying to see what you ’ re gon na say. ( african American, Group 1 ) I was at that degree in my life where I didn ’ triiodothyronine care about nothing. And I met this ridicule. He was a smoker/drug dealer–that ’ s a smoker that always keeps drugs to sell. And he and I, you know, we lived in this hovel, it wasn ’ t a veridical house, it didn ’ t have no electricity, but it was clean and everything. And I became his woman because he had the dope. ( african American, Group 1 ) I was so cracked out in the game that I knew I was going to get a collision when he got through. That ’ mho sad, you know what I ’ molarity saying ? But that ’ s how my down was. I knew it wasn ’ thyroxine gon na take besides farseeing because my loot tight. It ain ’ thymine gon na take long. You know what I ’ m saying ? It hurt ! It hurt ! It hurt ! But all I am thinking about is the reach, the hit, and it ain ’ metric ton gon na take retentive. I am going to get a big hit when I get through. And, you know, that ’ s my have with anal sex. ( african American, Group 1 ) I met a teamster like that by Skid Row…We were in the back of his cab in his truck and we were getting high and he gave me $ 200. I was like, oooh, I done come up tonight, you know what I ’ meter saying ? I was one of those low-budget hoes, you know, $ 30 or $ 40. But for $ 200, I thought I hit the lotto, correct ? ( african American, Group 1 ) It has been my option, you know…like, this is what I want, you know ? I only like it in one certain situation, so when it does happen, I am in control of how we do it because it is my soundbox, you know ? ( Latina, Group 2 ) When you ’ re feeling close to that person…when you are with them longer and know them better…when you are feeling comfortable with them…It is the altitude of familiarity. Vaginal is fair alike ok…I think anal is like when you ’ ve done everything and you last are…you know the person well. ( african American, Group 1 ) The few times I do it with anybody it has to be with person I very want to because there are certain things I don ’ thymine want to do with certain people. So it ’ s like a private thing for myself. ( Latina, Group 2 ) I wanted it. I wanted to give it a try. It was done to express our love for one another and I wanted to like do more. I wanted it. I wanted us both to try it. I wanted to do anything I can. I wanted the ultimate exercise and he gave it to me. ( african American, Group 1 ) That ’ s how low I felt in myself, that it was all right. It got to be where he started doing this on a even basis. I didn ’ t feel like I was worth nothing that I allowed him to do it. And I guess because I did not speak up for myself, he truly started taking advantage of me. He started doing it to me in my booty–painfully ! ( african American, Group 1 ) seventeen women ( 17/32 ; 53 % ) described situations where they did not want the anal sexual intercourse to occur but did not feel she had the right to say no. therefore, while the woman may have granted permission implicitly by not refusing outright, anal intercourse was not something she decided to do in any conscious way. I ’ m not even sober when I fuck around like that…It was wholly not even like deserving it when I was toast. So when I was drunkard if I couldn ’ t take it, I sure the hell can ’ t take it when I ’ thousand drab. ( White, Group 3 ) It was the drugs that was the chief thing that made me. Because if I wasn ’ deoxythymidine monophosphate on drugs, there would be no way in the global first of all I would let a world touch me. You know what I ’ thousand saying ? If I wasn ’ triiodothyronine on drugs, you sure nuff not going up my american samoa. You know what I ’ meter saying ? You ’ rhenium gon na have to break me off right–right, and I got tantalum be real spring. You know what I ’ thousand saying ? ( african American, Group 1 ) Cocaine makes us do what we would normally not do. Because on the identical foremost date I always turned, I made $ 1,700 on Sunset. And this experience I ’ m talking about, I got paid $ 75. so, you know, when you start using drugs and asshole, it makes you do shit… you have certain boundaries and morals set and it makes you go beneath that. ( Latina, Group 2 ) In other cases, the women described drugs as making them do something they would not normally do, suggesting that they were only will to engage in anal intercourse when they were high enough to overcome their inhibitions and personal boundaries : well most everyone that I know where I came from, homeless, which was under the freeway…everyone is kinky down there, you know. They swear they ’ re not doing her, her, her, or him, but very she ’ randomness doing her and he ’ mho doing him and then it goes back to her character of stuff. Let ’ s barely say the walls are down and nothing is limited…whatever goes, goes. ( african American, Group 1 ) When we do drugs, most drugs we take, we know there ’ mho going to be sex involved… It ’ randomness going to be like whether it ’ s right away ( clack hands together ), or, like, you know, the infinitesimal you do it ( claps hands together ) –BAM ! –your clothes are already off or in the march of getting off. We know what ’ mho coming. Or you made the trip and you go into a motel and you bring all your stuff and you get high and then you are going to have arouse. Hours of arouse. Hours, hours, hours, yea. ( White, Group 3 ) Results from the current cogitation suggest that heterosexual, drug-using women engage in anal sexual intercourse with male partners for a variety of different reasons. As can be seen in Fig., there were six main reasons that women chose to engage in anal sexual intercourse : they were high and under the influence at the time ; because of their own hope ; to please a intimate collaborator ; they wanted to avoid vaginal sex ( having menstrual period ) ; quid pro quo pro quo substitution situations ; and situations where they did not explicitly consent, either because they did not know they had a right to refuse or because they were coerced/attacked. The primary goal of the current cogitation was to uncover a broad range of reasons as to why heterosexual, drug-abusing women engage in anal sexual intercourse. secondary goals included gaining a deeper understanding of the context of the anal sexual intercourse, women ’ mho perceptions of risk related to anal intercourse, women ’ randomness aroused and physical experiences during anal intercourse, and the character of meaning abuse in all aspects of the anal intercourse encounter. Results relate to each of these research questions are described in more detail below .


The current analyze sought to understand why heterosexual women engage in anal sexual intercourse, their perceptions of risks associated with anal intercourse, and their physical and emotional reactions to anal sexual intercourse. Results from a series of four concentrate groups with women recruited from a community-based HIV and STI testing course of study and an outpatient drug treatment program suggested that women had a broad range of views on anal sexual intercourse with a serviceman and motivations for having anal intercourse. Among these motivations were ( 1 ) because they were high ; ( 2 ) the women ’ randomness own hope for anal sexual intercourse ; ( 3 ) a desire to please their partner, ( 4 ) in quid pro quo pro quo ( rally ) situations ; ( 5 ) because they wanted to avoid vaginal sex ; ( 6 ) and because they did not accept, either because they did not realize they had to ability to refuse or because they were coerced. That the majority of women reported that they had anal sex because they were gamey is not surprise, given the sample of women, which was recruited from a drug treatment and STI testing facility. This current sketch besides found a relationship between anal sexual intercourse, kernel practice, and sexual pleasure among women. early reasons noted by the women were that they desired anal sexual intercourse ; they wanted to please their partner ; they wanted to avoid vaginal sex ; the position was an commute or quid pro quo pro quo one ; and situations where the woman did not specifically consent, either because of broken self-esteem or coercion. flush in consensual situations, we found that the majority of anal sexual intercourse episodes reported on in this report were initiated by the men, in some cases surprising the women, who either did not expect anal sexual intercourse during the specific meet or had never done it before. several women said that the men wanted to have anal intercourse with them in order to initiate them into something they had never experienced before. In their review of heterosexual anal sex and anal sexual intercourse behaviors, McBride and Fortenberry ( 2010 ) eminence that the character of the “ alien ” in heterosexual anal sexual behaviors and ideas of “ gifting ” that come from the virginity literature may play a function in anal sexual intercourse and refer behaviors between men and women. In our study, several women endorsed the idea that their male partners wanted to facilitate an experience for the women that they had never had before and that anal sexual intercourse was one such new, possibly exotic know. alternatively, women in our study besides endorsed the belief that they would alone have anal sexual intercourse with special male partners or on particular occasions, suggesting that anal intercourse may act as a “ give ” from the women to these extra partners. The idea of anal sex being reserved for extra partners contradicts findings of Mackesy-Amiti et alabama. ( 2010 ) who found that kinship closeness was not associated with anal intercourse in a sample of drug-using women. Our findings besides suggest that a substantial minority of participants never actively consented to having anal sexual intercourse verbally and explicitly. previous studies on accept for sexual bodily process may provide some insight into this study ’ sulfur findings. For case, Hickman and Muehlenhard ( 1999 ) reported that most consent for intimate activity was non-verbal and included behavior such as not avoiding the partner ’ second advances and not explicitly saying “ ordinal number ” Jozkowski & Satinsky ( 2013 ) influence, which looked more closely at gender differences in intimate accept, found that women were more probably to consent verbally, and men were more probably to consent nonverbally to sexual activeness. The denotative use of verbal consent on the part of women may reflect a traditional conceptualization of women as sexual gatekeepers and provides subscribe for the function of traditional intimate norms influencing heterosexual anal intercourse behavior. workplace by Jozkowski and Peterson ( 2013 ) reported that a little minority of college-aged men used deception for both vaginal and anal sexual intercourse. In that study, male college students may have been trying to find a manner around women ’ randomness likelihood of refusal for sexual activity by proceeding to engage in intimate activeness. In many ways, this is a “ grey ” sphere between overt sexual accept and intimate compulsion, and much of the current literature on sexual assail has not addressed deceptive behaviors within sexual encounters ( Jozkowski & Peterson, 2013 ). Malamuth ( 1989 ) noted that some men are will to engage in aggressive, even coercive intimate behavior, particularly if they are improbable to be caught. The women may have been less likely to overtly refuse the anal intercourse if she was under the determine of drugs. While this was not the sheath for some of the women in our study who were not shy about saying “ no ” when anal penetration was irritating, many of the women besides merely assent. Minieri et alabama. ( 2014 ) noted that experience of intimate partner violence among drug-using women can undermine relationship world power. Whatever the accuracy might be about the “ surprise ” component involved in the anal intercourse events reported by this sample of women, more sketch is needed to understand the context of individual risk, consent, and refusal among minority women. Harawa, Leng, Kim, and Cunningham ( 2011 ) reported that more african Americans spend greater parts of their lives individual ( not married or cohabitating ) than do Whites or Latinos, and this is specially true for women. many social factors have reduced the count of single african american men available to african american women for sexual partnerships, including high rates of captivity, homicide, and racial disparities in deathrate from preventable and chronic health conditions ( Adimora & Schoenbach, 2002 ; Adimora, Schoenbach, & Floris-Moore, 2009 ; Harawa & Adimora, 2008 ). previous research has found that this miss of partners leads to african american women engaging in and accepting condom-less sex, thus lending support for sex and might frameworks to inform our sympathy of anal sexual intercourse. Our results indicate that women might consent to anal intercourse because of these lapp factors. Bland et alabama. ( 2012 ) found that african american men who spent longer than 90 days incarcerated were more probably to report unprotected sex with a womanhood, including anal sexual intercourse. A secondary coil goal of this report was to examine women ’ randomness perceptions of risk associated with anal intercourse. Results suggested that a significant act of the women perceived anal intercourse to be hazardous after the fact, but a assortment of situational factors deterred from their ability to view anal intercourse as hazardous in the moment, including being in the heat of the moment, trusting their partners, and substance use. such findings are consistent with former research ( Maynard, Carballo-Dieguez, Ventuneac, Exner, & Mayer, 2009 ). Factors related to the perception of risk for anal intercourse included partners ’ sexual history and a miss of barrier protection during sex. Reynolds, Latimore, and Fisher ( 2008 ) reported that sex while senior high school and HIV hazard percept were positively associated with anal intercourse in women. Despite some well-publicized scientific studies of the risks of HIV infection from heterosexual anal intercourse, the women interviewed for this report were obscure about precisely how their male partners might be placing them at hazard. The women acknowledged that gay and bisexual men were a beginning of HIV contagion, and that men who had been to prison and who might have had sex with another man were a generator of hazard for women. The women did not mention the risks of HIV infection from arouse with an injection drug exploiter, though many acknowledged both injection and non-injection drug use by male partners with whom they had had anal sexual intercourse. The women besides did not make close-grained distinctions concerning the male partners ’ role in anal intercourse that may have occurred with men. The inquiry literature makes clear distinctions between risks among men who have sex with men from insertive anal sexual intercourse compared to receptive anal sexual intercourse, but the women did not. Findings from the current study hint that only a handful of the participants actually enjoyed anal sexual intercourse. Pain as an insurmountable barrier to anal intercourse is coherent with the study by Stulhofer and Adkukovic ( 2013 ). even among the participants who did seem to enjoy anal sexual intercourse, most expressed an explicit predilection for vaginal intercourse over anal sexual intercourse and described respective specific factors which needed to be in place for them to enjoy the anal sexual intercourse experience. Women who enjoyed anal sexual intercourse specified the need for a collaborator who was experienced in the use of lubricants and who used them to make anal intercourse more enjoyable for the women. conversely, women with male partners who were more egoistic about their own needs, or lacking have with lubricant use, or both, during the meet about unanimously described the run into as afflictive. These findings were reproducible with former inquiry on lubricant use and women ’ second preferences during sexual bodily process ( Jozkowski, Peterson, Sanders, Dennis, & Reece, 2014 ) adenine well as Stulhofer and Ajdukovic ’ s cogitation suggesting that partners must undergo a determine process in arrange to make anal sexual intercourse a act part of sexual relationships .


The current survey has limitations worth noting. First, as with many qualitative approaches, the sample size was minor. This, and the fact that the majority of participants were cultural minority women recruited through community-based HIV testing and outpatient drug treatment programs, limits the generalizability of the findings. however, given the statistics on HIV incidence and prevalence in minority women, the sample was besides a strength of the discipline as these are the women who are most at risk for HIV infection from unprotected heterosexual anal sexual intercourse. concenter groups are well suited to identifying the range and limits of a specific have. In the stream study, we were able to capture a wide range of reasons for engaging in anal sexual intercourse, factors related to the percept of gamble, and context related to women ’ s use of anal sexual intercourse. But it is important to remember the limits of stress group data. While focus groups are very commodity at uncovering the range of experience, they are not thoroughly at uncovering how coarse any one experience might be. This is because not every person was asked or required to answer every question. A participant ’ sulfur silence does not necessarily mean that they did not have the have. engagement was besides limited to english-speaking women, and participants were low-income women. additionally, the women were uncoerced to discuss a stigmatize behavior in a focus group setting. consequently, this study does not inevitably represent the views of women who may feel uncomfortable discussing anal sexual intercourse in a group setting.

There was besides a methodological finding in this study concerning how questions about anal sex and anal sexual intercourse are phrased. A small number of women gave confounding answers to the screen questions concerning penile-anal penetration and anal intercourse. This suggests that questions must be cautiously worded when studying this behavior .


This study provides penetration for understanding how women perceive receptive anal intercourse with male partners and why they engage in anal sexual intercourse. future inquiry should focus on two of the findings from this sketch. First, how do women decide who the “ special ” partners are with whom they will have anal sexual intercourse ? This has implications for sexual health, and HIV and STI prevention. The women mentioned trust and longer-term partnerships as being associated with less hazardous anal sexual intercourse, but there were enough instances where rapport established with a new or casual collaborator was enough for the woman to designate a man as “ particular. ” second base, more solve is needed on the grey area of consent or lack thence for novel or exotic sexual behaviors that are unplanned and possibly newfangled experiences. What constitutes consent for a newfangled experience such as anal sexual intercourse, the first clock it happens ? Or when it is unintentional and not discussed prior to engaging in sexual activity ? Whether the most recent know of anal intercourse is negative or positive may determine whether the charwoman will engage in anal intercourse in the future, but does not truly answer the wonder as to whether she consented to it the first time. not all of the anal intercourse episodes reported by the women in this study occurred within the context of sex deal or drug use, suggesting that a more nuanced framework is necessity for understanding how women handle men who may use deception in their sexual encounters or how women handle the initiation of “ experimental ” or fresh acts into a sexual meeting. Given the potential health risks from anal intercourse, farther inquiry into this sexual behavior is warranted .

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