title: Women's experiences with anal sex: motivations and implications for STD prevention.
abstract: BACKGROUND
  Heterosexual anal intercourse is a highly efficient mode of HIV transmission, yet little is known about the contexts in which women engage in it, or when and with whom they use condoms. Similarly, sexuality and reproductive health research has paid little attention to female desire and pleasure-seeking.
  
  
  METHODS
  In-depth interviews were conducted in Boston in 2006 with 28 women who reported having had unprotected anal intercourse in the last year with a man who was HIV-positive or whose serostatus was unknown. Sexual scripting theory guided analyses of their experiences with and motivations to practice anal intercourse.
  
  
  RESULTS
  Participants engaged in anal intercourse for a wide variety of reasons: to experience physical pleasure, enhance emotional intimacy, please their male partners or avoid violence. Male partners usually initiated anal sex. Anal intercourse often occurred in the context of vaginal and oral sex. Among reasons women cited for not using condoms were familiarity with their partner and feeling that condoms made anal sex less pleasurable. Knowledge of HIV and STD risks did not appear to encourage condom use.
  
  
  CONCLUSIONS
  Women who perceive condom use during anal sex as limiting their pleasure or intimacy may be at increased risk for acquiring HIV. Consequently, interventions to promote safer anal intercourse must find a way to increase the use of barrier methods without decreasing pleasure or perceived intimacy between sexual partners.
authors.affiliation: Program in Clinical Psychology, Fordham University, New York, USA. maynard@pi.cpmc.columbia.edu
authors.forename: Emily
authors.initials: E
authors.lastname: Maynard
authors.forename: Alex
authors.initials: A
authors.lastname: Carballo-Diéguez
authors.forename: Ana
authors.initials: A
authors.lastname: Ventuneac
authors.forename: Theresa
authors.initials: T
authors.lastname: Exner
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D044469:Racial Groups; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D047568:Unsafe Sex; D055815:Young Adult