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Archives of Sexual Behavior. 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.

Anal intercourse is a highly efficient mode of HIV transmission. Nevertheless, there is evidence to suggest that anal intercourse is also widely practiced by women in the US 1 — 4. Given that anal intercourse is associated with higher rates of heterosexual HIV transmission than vaginal intercourse 10 — 13 , women who engage in unprotected anal intercourse with sexual partners of unknown or seropositive status may be at greater risk for acquiring HIV than women who do not practice anal intercourse or who use protection while doing so. Additionally, Halperin 1 found that women who engaged in anal intercourse were less likely to use condoms during anal intercourse than during vaginal intercourse. Most studies of heterosexual HIV transmission fail to distinguish between vaginal and anal intercourse in their assessments of coital acts, thus continuing to overlook anal intercourse as a potential source of HIV transmission. This oversight may be due to cultural taboos surrounding anal intercourse, including its association with homosexuality and its perceived lack of hygiene 1. A number of researchers have already pointed to the need for increased attention to anal intercourse as an understudied source of HIV transmission from seropositive men to their seronegative female partners 1 , 3 , 6 ,

Despite increasing pop culture coverage, anal sex is still heavily stigmatized. While this might be true for some women, assuming it goes for all women is completely unfair. Woman A: It honestly does hurt, be prepared, and use lots of lube if you want an easier time. Woman B: At times, it can be uncomfortable, but I don't recall that it ever really hurt.

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