title: Is anal sex a marker for sexual risk-taking? Results from a population-based study of young Croatian adults.
abstract: BACKGROUND
  There is evidence that anal sex is becoming increasingly popular among heterosexual women and men. Several studies carried out in especially vulnerable populations (e.g. sex workers and low-income youth) suggested that anal sex may indicate a more general propensity to sexual risk-taking.
  
  
  METHODS
  To assess whether this epidemiologically important finding holds in the case of young adults from the general population, we analysed data from a cross-sectional probability survey carried out in 2010 on 1005 Croatian women and men aged 18-25.
  
  
  RESULTS
  Anal intercourse was reported by 36.5% of 861 sexually experienced participants (42.7% of men and 29.8% of women). About one-third of them (34%) used a condom at most recent anal intercourse. The experience of anal sex was significantly associated (P<0.001) with all four indicators of sexual risk-taking (condom use at most recent vaginal intercourse, number of sexual partners in the past year, concurrent sexual relationships and anonymous sex in the past year), as well as with negative attitudes and beliefs about condom use (P<0.01). Sexual sensation-seeking mediated the relationship between anal sex and some of the sexual risk-taking behaviours.
  
  
  CONCLUSIONS
  According to the findings, heterosexual anal sex is directly and indirectly associated with increased behavioural risks of acquiring HIV and other sexually transmissible infections (STI). Sex education and STI prevention programs should focus on the importance of using protection when practicing anal sex.
authors.affiliation: Sexology Unit, Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, I. Lučića, 3, 10000 Zagreb, Croatia. astulhof@ffzg.hr
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Stulhofer
authors.forename: Valerio
authors.initials: V
authors.lastname: Baćak
mesh_terms: D017280:Condoms / Q000706:statistics & numerical data; D017523:Croatia; D003431:Cross-Cultural Comparison; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D011203:Poverty / Q000523:psychology / Q000639:trends; D011477:Sex Work / Q000523:psychology / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000523:psychology; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D014600:Utilization Review; D055815:Young Adult