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This study used qualitative methods to assess why women engage in heterosexual anal receptive intercourse AI with a male partner. Four focus groups which comprised women from diverse ethnicities were conducted. All groups were digitally recorded for transcription; transcripts were analyzed using the methods of grounded theory to determine themes.
The riskiness of AI was assessed within relationship contexts.
Past experience with AI including emotional and physical reactions was identified. Among the negative physical experiences of AI were pain and disliking the sensation, and uncomfortable side effects, such as bleeding of the rectum. Negative emotional experiences of AI included feelings of shame, disgust, and being offended by something her male partner did, such as spitting on his penis for lubrication. Positive physical experiences included liking the sensation. Many of the women also endorsed positive emotional experiences of AI, including that it was more intimate than vaginal sex, and that it was something they reserved only for special partners.
The majority of AI episodes were unplanned and not discussed prior to initiation. Pain during AI was mitigated by the use of lubricants or illicit drugs. Even those women who found pleasure in AI expressed a preference for vaginal intercourse. Recent interest in heterosexual anal intercourse has been generated from several research perspectives.
In the United States, general population surveys have suggested that the prevalence of anal intercourse among heterosexuals has increased over time Leichliter, Interest in anal intercourse has also come from research in human immunodeficiency virus HIV transmission. Several studies have quantified the increased risk of heterosexual transmission from one act of anal intercourse as compared to one act of vaginal intercourse Boily et al.
The increased risk of HIV transmission through anal intercourse has been well documented in studies of homosexual and bisexual men; however, there has only recently been interest in documenting comparable risks among heterosexual samples. The studies that have used heterosexual samples have generally focused on parts of the world, such as South Africa, that have not only high rates of anal intercourse among heterosexuals, but also high HIV prevalence in the general population and high s of concurrent partners among heterosexuals Kalichman et al.
Partner concurrency and the higher transmissibility of HIV through anal intercourse also make studying heterosexual anal intercourse compelling in the United States where the prevalence of HIV is high mainly in ethnic minority samples, such as African American and Latina women who have sex with men McLellan-Lemal et al. According to the U. Research with women who have male partners recently released from jail or prison has also yielded high rates of anal intercourse Bland et al.
Harawa and Adimora linked high incarceration rates among both men and women in the African American community with HIV through a of mechanisms, including the role incarceration plays in reducing the of male sexual partners available to African American women. There is also research literature on heterosexual anal intercourse among drug-using subsamples, which has found a relationship between anal intercourse and both injection and non-injection drug use Bogart et al. Mackesy-Amiti et al.
While this growing body of literature suggests that anal intercourse among heterosexual women may be more prevalent than ly assumed particularly among drug-abusing samples of womenthere is currently very little information about why these women are engaging in anal intercourse. Bandura stated that human behavior is learned from watching and interacting with other human beings. Women may learn about anal intercourse through male sex partners, and then they may suggest anal intercourse with new sex partners for a variety of reasons, including a desire to be responsive to his desires or because she has learned to like anal intercourse from the experience with a sex partner.
Through these traditional gender roles and sexual scripts e. Gender and power theory, which focuses on the sexual division of labor, sexual division of power, and social norms associated with relationships between men and women, may also inform our understanding of heterosexual anal intercourse Connell, Their model includes alcohol and drug use and high-risk steady partners who have been linked to anal intercourse. The current study sought to examine why heterosexual women engage in anal intercourse. Due to the limited nature of research on this topic, we opted for a more exploratory approach aimed at uncovering the broad range of reasons that women had for engaging in anal intercourse.
Focus group methods were selected to uncover the wide range of reasons that drug-abusing women may have for engaging in heterosexual anal intercourse. Focus groups are particularly well suited for uncovering a full range of opinions, experiences, or concerns about a topic Krueger, Focus groups were also preferred by the participating outpatient drug treatment program because participants were familiar with group activities and settings.
Women were invited to participate in the focus groups if they were at least 18 years of age and acknowledged having had anal intercourse with a man during a interview at CBRS and had past experience of illicit drug use. The majority had participated in some form of outpatient drug treatment, but some of the women had never received formal treatment for their drug use.
Further questioning revealed that all of the participants had had anal intercourse, but some did not count it as such if the man did not ejaculate or if the woman insisted he withdraw because of pain. Following the recommendations of Kruegereach focus group consisted of 7—10 participants, and all focus groups were conducted by the first author who has experience with group facilitation and has worked extensively with the population served at both the drug treatment center and CBRS. The focus groups were constituted so that all the women in each group were of the same ethnicity; group 1 was African American, group 2 was Latina, and group 3 was White, but group 4 was mixed with approximately equal proportions of African American and White women.
Upon arrival at the focus group location, participants were first informed about the nature of the study and all associated risks and benefits. Informed consent was a two-stage process: women consented first to participate in the focus group and ed an informed consent form approved by the CSULB Institutional Review Board. The second stage consent process required the women to give separate consent to have the focus group digitally recorded for later transcription and coding. Only women who were willing to consent at both stages, that is, to participate in the focus group and to allow the group to be recorded, participated in the final focus groups.
None of the women refused to be audio taped. Women then answered a brief demographic questionnaire that elicited information on their age, self-reported ethnicity, and the of biological children, whether they had had oral, vaginal, and anal intercourse at any point in their lifetime, and whether their last sexual encounter was with a man or a woman. The demographic questionnaire was followed by a description of focus group procedures and ground rules. Following the recommendations of Kruegerthe focus group protocol consisted of five generally worded questions about heterosexual anal intercourse with male partners, how often it had occurred in their lifetime, the frequency of anal intercourse with their current or most recent sexual partner, the context in which the anal intercourse event took place type of partner, such as new, casual, and regularthe role of alcohol and illicit substances in facilitating the anal intercourse, and other relevant characteristics of the male partners known to be bisexual, incarceration history and any other information the women were willing to provide concerning the anal intercourse event itself e.
Participants were allowed to respond spontaneously to each question and were not required to seek permission to speak or speak in a deated order. Although each participant was not required to answer each question, the facilitator did encourage participation from all women and made efforts to elicit diverging perspectives. The audio files produced by the recording equipment in MP3 format were transcribed verbatim and imported into Dedoosean on-line qualitative analysis program that facilitates coding, sorting, and displaying mixed method data.
In the second phase, a constant comparison method was used to group and organize the marginal codes conceptually. This inductive process resulted in a hierarchically organized codebook containing codes and subcodes that emerged from the data itself. In the third phase, Dedoose was used to mark excerpts from the transcripts. Excerpts were identified both conceptually based on the beginning and ending of a distinct idea and contextually including all necessary information for accurate interpretation.
The codebook was then ed to Dedoose and used to as applicable codes to the excerpts. Dedoose was used to assess inter-rater reliability utilizing a random selection of one-third of the excerpts created by the second author. In most cases, disagreements involved omissions. This occurred when one person applied a code that was overlooked by the other person. When these omissions were counted as disagreements, the kappa coefficient was.
When these omissions were left out of the calculations, kappa increased to. All omissions and discrepancies were then discussed by the coders, and a consensus approach was used to as final codes. Each of these codes and sample quotes are described in detail below.
The primary goal of the current study was to uncover a wide range of reasons as to why heterosexual, drug-abusing women engage in anal intercourse. related to each of these research questions are described in more detail below. from the current study suggest that heterosexual, drug-using women engage in anal intercourse with male partners for a variety of different reasons.
As can be seen in Fig. Every time I have had anal sex it was because I was either extremely drunk or extremely loaded; every time I have had anal sex I was on drugs. African American, Group 1. In some of these cases, the women described being more interested in anal intercourse when they were high, suggesting that substance use increased their own sexual desire:.
Or you made the trip and you go into a motel and you bring all your stuff and you get high and then you are going to have sex. Hours of sex. Hours, hours, hours, yeah. White, Group 3. Well most everyone that I know where I came from, homeless, which was under the freeway…everyone is kinky down there, you know.
In other cases, the women described drugs as making them do something they would not ordinarily do, suggesting that they were only willing to engage in anal intercourse when they were high enough to overcome their inhibitions and personal boundaries:. Cocaine makes us do what we would usually not do. So, you know, when you start using drugs and shit, it makes you do shit… you have certain boundaries and morals set and it makes you go beneath that. Latina, Group 2. Let me tell you, crack will make some people do anything…sell your baby, sell you. No, crack will make you do anything.
Still others explained that having anal intercourse without using substances would be too painful so they are only willing to have anal intercourse when they are high:. It was the drugs that was the main thing that made me. Thus, while the woman may have granted permission implicitly by not refusing outright, anal intercourse was not something she decided to do in any conscious way.
It got to be where he started doing this on a regular basis. And I guess because I did not speak up for myself, he really started taking advantage of me. He started doing it to me in my booty—painfully! I suffer from depression and certain stuff like that. White, Group 4. In some of these cases, women simply described engaging in anal intercourse because they personally enjoy it:.
I wanted it. I wanted to give it a try. It was done to express our love for one another and I wanted to like do more. I wanted us both to try it. I wanted to do anything I can. I wanted the ultimate workout and he gave it to me. In other cases, women described only enjoying anal intercourse in specific circumstances such as with people they know and trust very well:.
Others described only having anal intercourse in certain positions or when certain conditions were met:. It has been my choice, you know…like, this is what I want, you know? I only like it in one certain position, so when it does happen, I am in control of how we do it because it is my body, you know?Women want sex Cunningham
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