Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 41, Number 3, September 2009

Women’s Experiences with Anal Sex: Motivations and Implications for STD Prevention

By Emily Maynard, Alex Carballo-Diéguez, Ana Ventuneac, Theresa Exner and Kenneth Mayer

CONTEXT: 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.

Perspectives on Sexual and Reproductive Health, 2009, 41(3):142–149

DOI:10.1363/4114209







 

AUTHOR AFFILIATIONS

Emily Maynard is a doctoral student, Program in Clinical Psychology, Fordham University, New York. Alex Carballo-Diéguez is research scientist, professor of clinical psychology and associate director; Ana Ventuneac is project manager;