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Anal Sex Among HIV-Seronegative Women at High Risk of HIV Exposure
Gross, M | Holte, SE | Marmor, M | Mwatha, A | Koblin, BA | Mayer, KH
JAIDS Journal of Acquired Immune Deficiency Syndromes [JAIDS J.
Acquired Immune Defic. Syndromes]. Vol. 24, no. 4, pp. 393-398.
Aug 2000.
To assess the prevalence and the sociodemographic and behavioral
correlates of anal sex in a cohort of HIV-seronegative U.S. women
at high risk of HIV exposure, we administered a risk assessment
using audio computer-assisted self-interview (A-CASI). Of 1268
sexually active women, 432 (32%) reported anal sex in the previous
6 months. Compared with women who did not report anal sex, those
who did had more unprotected vaginal sex (median of 11 versus 7
episodes; p < .001) and a higher proportion of unprotected sexual
(vaginal plus anal) episodes (median of 0.90 versus 0.81; p =
.01). Anal sex was reported by higher proportions of women who did
not always use condoms, who used crack in the past year, who were
less than or equal to 35 years of age, with no formal education
beyond high school, who had had a diagnosed sexually transmitted
disease in the previous year, a primary male sex partner, and a
male sex partner with a history of injecting use. Women were more
likely to report anal sex by A-CASI than during
interviewer-administered risk assessments (odds ratio [OR], 9.00;
95% confidence interval [CI], 1.14-71.0). A less biased method of
ascertainment may account for the large proportion of women
reporting anal sex. Given increased vaginal risk among women
reporting anal sex, the relative importance of anal sex in
heterosexual transmission merits further study. Behavioral and
biomedical prevention strategies effective for anal as well as
vaginal sex are needed.
 Descriptors: Article Subject Terms Acquired immune deficiency syndrome | Anus | Drug
abuse | Females | Heterosexuality | Human immunodeficiency virus | Risk assessment | Sexual behavior | Sexually-transmitted diseases | Vagina | Article Taxonomic Terms Human immunodeficiency virus
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