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Try out PMC Labs and tell us what you think. Learn More. ificant correlations existed between HAI and a high-risk sexual history. HAI is prevalent in this population. Nurses must educate adolescent female patients about risks associated with HAI. Because they are consistently receptive partners, women incur much greater risk from heterosexual AI HAI than do their male partners. Furthermore, evidence suggests that some young people may view AI as being less risky than other sexual behaviors.

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It should be noted that these studies did not address HAI. Tschann, Adler, Millstein, Gurvey, and Ellen examined the relationship between the SRP of adolescent sexual partners and condom use during vaginal intercourse. An extensive review of the role of gender-based power in determining reproductive health outcomes concluded that understanding gender-based power dynamics is essential to improving reproductive health Blanc, For both RCTs, young women completed a baseline assessment before participating in the intervention.

The data presented here are from those baseline assessments. Details about the intervention and the of the RCT have been published elsewhere Roye et al.

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In the first RCT, eligibility requirements also included current use of a hormonal method of contraception all of which were available when the study began and plans to continue such use. Young women not currently using a hormonal method, but who came to Planned Parenthood to get a prescription for one, were also included in that study.

This was an eligibility criterion because the purpose of the study was to test the efficacy of the intervention in promoting condom use among teens who were hormonally protected from pregnancy. The second study included sexually active teens regardless of hormonal use. It was conducted to test modifications that were made to the intervention; the baseline assessment was modified as well. For both Black female anal sex, young women who presented for reproductive health care were recruited by a trained female research assistant RA from the waiting room.

Those who agreed to see if they might be eligible to participate in a study were escorted to a separate room where the study was described; those who agreed to participate were given a brief screening questionnaire to determine eligibility. Those who were eligible and who ed consent completed an in-depth questionnaire about their sexual behaviors.

The sample from the first pre-intervention assessment included young women, ranging in age from 15 to 21 years. The mean and median ages were 18 years.

Because New York State mandates confidential care for minors seeking reproductive health care, the law states that these young people can consent to reproductive-health-related research without requiring parental consent. All participants ed consent prior to study participation. They were informed that the data would be confidential, that only a study would identify them, and that they could withdraw from the study at any time without repercussions. Young women completed the questionnaire alone in a room, on a laptop computer.

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It was modified for use with adolescents in this study and updated to incorporate current HIV prevention information. Sexual behaviors, sexual history, self-efficacy for condom use, and intention to use condoms were measured.

In-depth information was elicited about the of protected and unprotected sexual acts in which each young woman had engaged for each intercourse type and with each partner type. If respondents had more than one partner, or more than one partner type, they answered questions about each.

Prevalence and correlates of heterosexual anal intercourse among black and latina female adolescents

In the present study, a factor analysis was conducted on the 15 items comprising the Relationship Control subscale. A KMO of. Sample items on this scale included: If I asked my partner to use a condom, he would get violent; Most of the time, we do what my partner wants to do; and I am more committed to our relationship than my partner is.

However, the Decision Making Control subscale did not have adequate psychometric properties.

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KMO was. In addition, 3 factors emerged, suggesting that the scale was not measuring a unitary concept with this sample. Therefore, a total score was not computed and only the Relationship Control subscale is discussed. For the first study, the primary research question was to identify risk factors for AI. Potential predictor variables included dichotomous risk factors e. Bivariate analyses chi-square tests were initially conducted to identify ificant risk factors for AI.

A logistic regression that included all risk factors yielding ificant association with AI was then conducted.

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The multivariate test permitted comparison of the magnitude of risk posed by these factors, and as these risk factors would be expected to overlap, the multivariate model would also identify the unique predictors of AI. To test for linear Black female anal sex non-linear relationships, scores were broken into tertiles, which were based on where scores fell along the range of scores 1—4. Chi-square analysis was then used Black female anal sex test the association between the power tertiles and AI.

Data for each RCT were analyzed separately because there was a fundamental difference between the two samples, which could potentially affect AI behaviors. The first sample was hormonally protected from pregnancy while the second sample was not. Forty-seven percent of those who had engaged in AI had done so in the 2 months. Fifty-two young women reported AI with a main partner, 7 with a casual partner, and 3 with a new partner; 23 chose not to answer the query regarding the type of partner with whom they had engaged in AI.

Fewer than one third We wanted to determine if the youth in our studies were hormonally protected from pregnancy when they engaged in AI, hypothesizing that if they were, they were likely not to be having AI to avoid pregnancy.

We, therefore, asked questions about current use of a hormonal contraception method, and having had anal sex in the 2 months. The data were examined by ethnicity, as the literature has suggested ethnic differences in the rates of HAI Laumann et al. Data for other partner types was not reported because there were too few cases to warrant analysis. Young women who had ever had AI were ificantly more likely to report a high-risk sexual history.

Why women engage in anal intercourse: from a qualitative study

They had been younger at first vaginal intercourse, were ificantly less likely to have used a condom at last vaginal intercourse with their main partner, and were more likely to report a history of pregnancy, STIs, and abuse by a partner or by someone close to them see Table 2. A logistic regression was run in which the correlates of AI were entered as predictors of AI. All except pregnancy remained unique predictors of AI see Table 3.

Recruitment for the second RCT was similar to that of the first, as discussed, except for a requirement to be using or starting use of a hormonal method because we wanted to test the intervention with a broader cohort of young women. None reported using a condom during AI with their main partner. Only condom use with main partner was examined, as there were too few women with other partner types to analyze. Eleven of these young women were Black female anal sex a hormonal method of contraception. Data were also examined by age to see whether age influenced history of AI.

However, there was no correlation between age dichotomized as younger and older and having had AI in the 2 months. Chi-square analyses could not be run on Black teens because too few had engaged in AI. Because the SRPS score was shown in one study to correlate with condom use during vaginal intercourse Pulerwitz et al.

Those with scores in the lowest tertile were least likely to use condoms during vaginal intercourse and those in the highest tertile were most likely to do Black female anal sex, even though, as noted above, no respondents who stated that they had engaged in AI reported using a condom during AI. HAI is a prevalent behavior in these samples of Black and Latina female adolescents.

From that framework, the prevalence of HAI in a hormonally protected, non-virginal sample is perplexing.

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Clearly, factors other than preserving vaginal virginity or preventing pregnancy likely are at work. In addition, in the initial analysis of the data it became clear that young women who reported engaging in AI also reported a high-risk sexual history: younger at first vaginal intercourse, less likely to use a condom during vaginal intercourse, more likely to have had an STI, and more likely to have been abused by a partner or Black female anal sex someone close to them.

This is of particular concern because these risk factors are associated with increased HIV infection rates Beyrer, Although those with low scores on the RCS did indeed report higher levels of AI, the relationship between the RCS and AI was not linear, as it is with condom use during vaginal intercourse. However, these findings should be viewed with caution due to the small s, especially in the low and medium power. However, the social-psychological context of partner interactions around refusing AI and using condoms during AI may be quite different than that for vaginal intercourse.

More research is needed in order to understand that relationship. Furthermore, young women were less likely to use condoms during anal than during vaginal intercourse.


The data do not allow us to analyze the reasons for this. It is possible that in these samples, condom use in general was primarily for disease, rather than for pregnancy, prevention. Clearly, condom use during AI is exclusively for disease prevention.

In the first sample, most of the young women were hormonally protected from pregnancy, yet they were more likely to use condoms during vaginal than during anal intercourse.

Additional possible explanations for these findings include the following. In a study of a national sample of undergraduate students, respondents were asked about the behaviors they considered to be having sex. Consequently, it is possible that young Black female anal sex may not consider it to be a normative behavior.

Therefore, they may feel that their typical notions of risk reduction do not apply, or that they apply in a different, as-yet-undetermined, way. Age was also examined as a possible predictor of AI. A ificant correlation was found between older age and history of AI. However, that may simply be explained by the fact that older teens may have been sexually active for a longer period of time, and that they, therefore, may have had more sexual experiences.