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Acknowledgements We wish to thank the Gauteng Department of Health and the Tshwane Health District for permitting this study at their organizations. Our qualitative study was part of a larger study on rectal microbicide acceptability among men who have sex with men MSM and women who practice anal intercourse.

Women's experiences with anal sex: motivations and implications for std prevention.

Thousand Oaks, CA: Sage; Given that the need tiime female-controlled alternatives to condoms encompasses products that can tije used intrarectally as well as vaginally, rectal microbicides should be marketed to women as well as to MSM. A 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 136 Although it was not clear as to what exactly they felt they were being punished for, some participants associated the punishment with many wrong things they had done before, while another participant felt he was being punished by God for refusing to go to church.

In contemporary American sexual culture, the predominant sexual script is one of male pursuit and female acquiescence It went off……I could not think about anything…. Overpowering the victim prior to raping them is experjence as one of the tactics used by rapists to overpower and instill fear in their victims Mgolozeli and Duma, ; Quarshie et al. By equating exceptional sex with exceptional relationships, women sought to express their love, commitment, and openness towards theirpartners through their willingness to have anal intercourse, as this woman did with her husband: Sarah: Anal sex?

Although nearly all of the participants were aware that unprotected anal intercourse might put them at risk for sexually transmitted infections, this knowledge apparently did not translate into behavioral change, as evidenced by the participant who had unprotected anal intercourse with her HIV-positive partner. Misegades L, et al.

Sexual coercion and sexual desire: Ambivalent meanings of heterosexual anal sex in Soweto, South Africa. Generalized human distrust This subordinate theme emerged from participants' reports that after the rape incident they did not trust anyone. I felt like they made me be their wife because those men fjrst with me and used me, and I do not see myself as a man that I used to know……I feel like a woman.

Taking sexual scripting theory intohowever, a more complex story emerges from the data. Participants in this study reported that the rape scar was permanent and something that they would live with for the rest of their lives as they felt there was nothing they could do about it and that they would never forget it.

Erickson PI, et al. In this sense, anal intercourse was sought not only for the physical pleasure that it afforded women, but also valued as a marker for exceptional sex. I never thought in my life, I would be forced by women to [have] sex. 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.

Intense emotions attached to being raped This superordinate theme emerged from data in which participants reported the intense emotions that they attach to the rape experience. Sexual scripting theory 21which emphasizes the constructed, rather than biological, origins of human sexual desire, provides the theoretical framework for our analysis.

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This notion of sexuality does not so much uphold the masculine model of the autonomous sexual actor seeking his own satisfaction, but instead identifies women--and by extension, their male partners--as sexual beings by virtue of their relational stance towards others. Additionally, Halperin 1 found that women who engaged in anal intercourse were less likely to use condoms experiencee anal intercourse than during vaginal intercourse.

To me this feels like I'm now HIV positive. No, I couldn't. And it feels good.

1. introduction

Women were recruited through flyers; palm cards; outreach at community based organizations, colleges, and at community events; Internet and print media advertising; referrals through other studies or staff at the community clinic; and word of mouth. South African sexual assault survivors' experiences of post-exposure prophylaxis and individualized nursing care: a qualitative study.

I feel like a woman and I don't want to feel like a woman…. Future studies should seek to quantitatively xeperience HIV and STI risk among a larger and more representative sample of women who engage in anal intercourse.

Holland J, et al. There were intense emotions that participants attached to being raped, such as persistent anger, deep-seated generalized hatred, generalized human distrust, and persistent occupation with revenge. In this context, male initiative alone may not necessarily indicate a lack of female agency, but rather serve as a marker for the presence of a strong sexual script that dictates male pursuit and female acquiescence or rejection of male desire.

Sexual transmission of HIV: Infectiousness and prevention. Given that anal intercourse is associated with higher rates of heterosexual HIV transmission than vaginal intercourse 10 — 13women 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.

And it feels good. Pleasure-Seeking and Sexual Risk Although researchers have documented the relationship between pleasure-seeking behavior and sexual risk-taking in men who have sex with men 36 — 38it is not yet clear how pleasure-seeking may be related to sexual risk-taking among women.

An overpowering physical restraining experience This subordinate theme emerged from data in which the participants reported to have been restrained by perpetrators who used power to hold the victims' hands or hold their bodies very tight to an extent they could not fight them off or physically move so that the perpetrators could then rape them.

My head stopped working I was just opening my eyes and I couldn't do anything.

Women who have anal sex: pleasure or pressure? implications for hiv prevention

Not good. Vernazza PL, et al.

Forced oral sex This subordinate theme emerged from data in which the participants reported that the wihte forcefully inserted their penises into the victims' mouths and instructed the victims to suck them until they ejaculated. Using the software NVivo, all transcripts were coded independently by staff members who then compared the codes, compared discrepancies, and discussed them until consensus was reached.

Taking sexual scripting theory intohowever, a more complex story emerges from the data. On the other hand, HIV and STI interventions geared mal women who have unprotected anal intercourse must not lose sight of societal factors that disadvantage women.

Human tonic immobility: measurement and correlates. And I just found a new part of my body I can enjoy. Studies in Family Planning.

However, just as the sensation of physical pleasure during anal intercourse varied among participants, so did the importance that participants placed on physical pleasure alone as a motivating factor for engaging in anal intercourse.