Skip to main content

Advertisement

SpringerLink
Log in

Gender Differences in Heterosexual Anal Sex Practices Among Women and Men in Substance Abuse Treatment

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Heterosexual anal intercourse (HAI) is an understudied risk behavior among women and men in substance abuse treatment. Rates of HAI for women (n = 441) and men (n = 539) were identified for any, main and casual partners. More men (32.8 %) than women (27.1 %) reported engaging in HAI in the previous 90 days. These rates are higher than those reported for both men (6.0–15.9 %) and women (3.5–13.0 %) ages 25–59 in the National Survey of Sexual Health and Behavior. Men were significantly more likely to report HAI with their casual partners (34.1 %) than women (16.7 %). In a logistic regression model generated to identify associations between HAI and variables previously shown to be related to high risk sexual behavior, being younger, bisexual, and White were significantly associated with HAI. For men, having more sex partners was also a significant correlate. HAI is a logical target for increased focus in HIV prevention interventions.

Resumen

El sexo anal heterosexual (SAH) no se ha estudiado bastante como una conducta de riesgo en mujeres y hombres en tratamiento de abuso de sustancia. Las tasas de SAH para mujeres (n = 441) y hombres (n = 539) fueron identificadas para parejas principales, casuales o cualquier otra pareja. Más hombres (32.8 %) que mujeres (27.1 %) reportearon haberse involucrado en SAH durante los 90 días anteriores. Estas tasas son más altas que las reporteadas para hombres (6.0–15.9 %) y mujeres (3.5–13.0 %) de 25–29 años en la National Survey of Sexual Health and Behavior (Encuesta Nacional de Salud y Conducta Sexuales). Los hombres fueron significativamente más propensos a reportear SAH con sus parejas casuales (34.1 %) que las mujeres (16.7 %). En un modelo de regresión logística diseñado para identificar las asociaciones entre SAH y variables anteriormente mostradas a ser relacionadas con conductas sexuales de alto riesgo, ser más joven, bisexual, y caucásico se asoció significativamente con SAH. Para los hombres, tener más parejas sexuales fue también un correlato significativo. SAH es un objetivo lógico para mayor enfoque en las intervenciones de prevención de VIH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Center for Disease Control and Prevention: Diagnoses of HIV Infection and AIDS in the United States and Dependent Areas, 2009. February 2011 http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Accessed 22 May 2012.

  2. Calsyn DA, Hatch-Maillette M, Tross S, Doyle SR, Crits-Christoph P, Song YS. Motivational and skills training HIV/sexually transmitted infection sexual risk reduction groups for men. J Subst Abuse Treat. 2009;37(2):138–50.

    Article  PubMed  Google Scholar 

  3. Tross S, Campbell ANC, Cohen LR, Calsyn D, Pavlicova M, Miele GM, et al. Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: results of nida clinical trials network trial. J Acquir Immune Defic Syndr. 2008;48:581–9.

    Article  PubMed  Google Scholar 

  4. Kalichman SC, Cherry C, Browne-Sperling F. Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for inner-city African American men. J Consult Clin Psychol. 1999;67:959–66.

    Article  CAS  PubMed  Google Scholar 

  5. Pyeatt M, Tirado A. Nia facilitator’s Guide. Dallas: University of Texas Southwestern; 2008.

    Google Scholar 

  6. Villarruel AM, Jemmott JB, Jemmott LS. A randomized controlled trial testing an HIV prevention intervention for latino youth. Arch Pediatric Adolesc Med. 2006;160:1–6.

    Google Scholar 

  7. Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta analysis of observational studies. Lancet Infect Dis. 2009;9:118–29.

    Article  PubMed  Google Scholar 

  8. Halperin D. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, part I. AIDS Patient Care and STDs. 1999;13:717–30.

    Article  CAS  PubMed  Google Scholar 

  9. Mastro TD, Kitayaporn D. HIV type 1 transmission probabilities: estimates from epidemiological studies. AIDS Res Hum Retroviruses. 1998;14:S223–7.

    Article  PubMed  Google Scholar 

  10. Powis B, Griffiths P, Gossop M, Strang J. Heterosexual anal intercourse, health risks and drug use: a review with special attention to drug users. Drug Alcohol Rev. 1995;14:223–9.

    Article  CAS  PubMed  Google Scholar 

  11. Voellner B. AIDS and heterosexual anal intercourse. Arch Sex Behav. 1991;20:233–76.

    Article  Google Scholar 

  12. Padian N, Shiboski S, Jewell N. The effect of number of exposures on the risk of heterosexual HIV transmission. J Infect Dis. 1990;161(5):883–7.

    Article  CAS  PubMed  Google Scholar 

  13. Risser JMH, Padgett P, Wolverton M, Risser WL. Relationship between heterosexual anal sex, injection drug use and HIV infection among black men and women. Int J STD AIDS. 2009;20:310–4.

    Article  CAS  PubMed  Google Scholar 

  14. Wilton L, Herbst JH, Coury-Doniger P, Painter TM, English G, Alvarez ME, et al. Efficacy of an HIV/STI prevention intervention for black men who have sex with men: findings from the many men, many voices (3MV) project. AIDS Behav. 2009;13:532–44.

    Article  PubMed  Google Scholar 

  15. Jones KT, Gray P, Whiteside YO, Wang T, Bost D, Dunbar E, et al. Evaluation of an HIV preventinon intervention adapted for black men who have sex with men. Am J Public Health. 2008;98:1043–60.

    Article  PubMed  Google Scholar 

  16. Erickson P, Bastani R, Maxwell AE, Marcus AC, Capell FJ, Yan KX. Prevalence of anal sex among heterosexuals in California and its relationship to other AIDS risk behaviors. AIDS Educ Prev. 1995;7(6):477–93.

    CAS  PubMed  Google Scholar 

  17. Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behaviors, relationships, and perceived health status among adult women in the United States: Results from a national probability sample. J Sexual Med. 2010;7(Suppl 5):277–90.

    Article  Google Scholar 

  18. Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behaviors, relationships, and perceived health among adult men in the United States: results from a national probability sample. J Sexual Med. 2010;7(Suppl 5):291–304.

    Article  Google Scholar 

  19. Tian LH, Peterman TA, Tao G, Brooks LC, Metcalf C, Malotte CK, et al. Heterosexual anal sex activity in the year after an STD clinic visit. Sex Transm Dis. 2008;35(11):905–9.

    Article  PubMed  Google Scholar 

  20. Reynolds GL, Fisher DG, Napper LE, Fremming BW, Jansen MA. Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles county. Women’s Health Issues. 2010;20(6):414–9.

    Article  PubMed  Google Scholar 

  21. Zule WE, Costenbader EC, Meyer WJ Jr, Wechsberg WM. Methamphetamine use and risky sexual behaviors during heterosexual encounters. Sex Transm Dis. 2007;34(9):689–94.

    Article  CAS  PubMed  Google Scholar 

  22. Center for Disease Control and Prevention. Methamphetamine use and HIV risk behaviors among heterosexual men-preliminary results from five northern California counties, december 2001–november 2003. MMWR. 2006;55(10):273–7.

    Google Scholar 

  23. Bogart LM, Kral AH, Scott A, Anderson R, Flynn N, Gilbert ML, et al. Sexual risk among injection drug users recruited from syringe exchange programs in California. Sex Transm Dis. 2005;32(1):27–34.

    Article  PubMed  Google Scholar 

  24. Molitor F, Truax SR, Ruiz JD, Sun RK. Association of methamphetamine use during sex with risky sexual behaviors and HIV infection among non-injection drug users. The Western J Med. 1998;168:93–7.

    CAS  Google Scholar 

  25. Baldwin J, Baldwin J. Heterosexual anal intercourse: an understudied, high-risk sexual behavior. Arch Sex Behav. 2000;29:357–73.

    Article  CAS  PubMed  Google Scholar 

  26. Seidlin M, Vogler M, Lee E, Lee YS, Dubin N. Heterosexual transmission of HIV in a cohort of couples in New York City. AIDS. 1993;7:1247–54.

    Article  CAS  PubMed  Google Scholar 

  27. Leichliter JS. Heterosexual anal sex: part of an expanding sexual repertoire. Sex Transm Dis. 2008;35(11):910–1.

    Article  PubMed  Google Scholar 

  28. Padian N, Shiboski S, Glass S, Vittinghoff E. Heterosexual transmission of human immunodeficiency virus (HIV) in northern California: results from a ten-year study. Am J Epidemiol. 1997;168(4):350–7.

    Article  Google Scholar 

  29. Pendergrast ML, Urada D, Podus D. Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs. J Consult Clin Psychol. 2001;69(3):389–405.

    Article  Google Scholar 

  30. Davis W, Johnson B, Randolph D, Liberty H. Risks for HIV infection among users and sellers of crack, powder cocaine and heroin in central Harlem: implications for interventions. AIDS Care. 2006;18(2):158–65.

    Article  PubMed  Google Scholar 

  31. Strathdee S, Sherman S. The role of sexual transmission of HIV infection among injection and non-injection drug users. J Urban Health. 2003;80(4 (suppl 3)):iii7–14.

    PubMed  Google Scholar 

  32. Buchacz K, van der Straten A, Shiboski S, Gomez C, Padian N. Sociodeographic, behavioral, and clinical correlates of inconsistent condom use in HIV-serodiscordant heterosexual couples. J Acquir Immune Defic Syndr. 2001;28(3):289–97.

    CAS  PubMed  Google Scholar 

  33. Raj A, Saitz R, Cheng D, Winter M, Samet J. Associations between alcohol, heroin, and cocaine use and high risk sexual behaviors among detoxification patients. Am J Drug Alcohol Abuse. 2007;33:169–78.

    Article  PubMed  Google Scholar 

  34. Meade CS, Sikkema KJ. HIV risk behavior among adults with severe mental illness: a systematic review. Clin Psychol Rev. 2005;25:433–57.

    Article  PubMed  Google Scholar 

  35. Meade C. Sexual risk behavior among persons dually diagnosed with severe mental illness and substance use disorder. J Subst Abuse Treat. 2006;30:147–57.

    Article  PubMed  Google Scholar 

  36. Meade CS, Sikkema KJ. Psychiatric and psychosocial correlates of sexual risk behavior among adults with severe mental illness. Community Ment Health J. 2007;43(2):153–69.

    Article  PubMed  Google Scholar 

  37. Cockrell JR, Folstein MF. Mini-mental state examination (mmse). Psychopharmacol Bull. 1988;24(4):689–92.

    CAS  PubMed  Google Scholar 

  38. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:196–8.

    Article  Google Scholar 

  39. Calsyn DA, Wells EA, Saxon AJ, Jackson R, Heiman JR. Sexual activity under the influence of drugs is common among methadone clients. Rockville : National Institute on Drug Abuse, 2000 Contract No.: 00-4773.

  40. Meyer-Bahlburg H, Ehrhardt A, Exner TM, Gruen RS. Sexual risk behavior assessment schedule-adult-armory interview. New York: New York State Psychiatric Institute and Columbia University; 1991.

    Google Scholar 

  41. Sohler N, Colson PW, Meyer-Bahlburg HFL, Susser E. Reliability of self reports about sexual risk behaviors for HIV among homeless men with severe mental illness. Psychiatric Services. 2000;51:814–6.

    Article  CAS  PubMed  Google Scholar 

  42. Gross M, Holte SE, Marmor M, Mwatha A, Koblin BA, Mayer KM. Anal sex among HIV-seronegative women at high risk of HIV exposure. J Acquir Immune Defic Syndr. 2000;24:393–8.

    CAS  PubMed  Google Scholar 

  43. Metzger DS, Koblin B, Turner C, Navaline H, Valenti F, Holte S. Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. HIVNET vaccine preparedness study protocol team. Am J Epidemiol. 2000;152(2):99–106.

    Article  CAS  PubMed  Google Scholar 

  44. Bruning J, Kintz B. Computational Handbook of Statistics. 3rd ed. Glenview: Scott Foresman; 1987.

    Google Scholar 

  45. Howard D, Latkin C. A bridge over troubled waters: factors associated with non-injection drug users having injection drug using sex partners. J Acquir Immune Defic Syndr. 2006;43:325–30.

    Article  Google Scholar 

  46. PASW Statistics. Release 18. ed. Chicago, IL: IBM Corporation. 2009.

  47. Cheng WS, Garfein RS, Semple SJ, Strathdee SA, Zians JK, Patterson TL. Methamphetamine users binge use and sex and drug use behaviors among HIV(−), heterosexual methamphetamine users in San Diego. Subst Use Misuse. 2010;45:116–33.

    Article  PubMed  Google Scholar 

  48. Calsyn D, Berns S, Hatch-Maillette MA, Tross S. Real Men Are Safe (REMAS): A Gender-Focused HIV and Sexual Risk Reduction Intervention for Men in Substance Abuse Treatment. Seattle, WA: CTN Dissemination Library; 2009. Available from: http://ctndisseminationlibrary.org/display/397.htm.

  49. Kalichman SC, Johnson JR, Adair V, Rompa D, Multhauf K, Kelly JA. Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men. J Pers Assess. 1994;62:385–97.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). Grants:U10 DA13714 (D. Donovan, PI), U10 DA 13035 (Edward Nunes and John Rotrosen, Co-PIs), U10 DA 013727 (Kathleen Brady, PI), and K23 DA028660 (Christina Meade, PI). The authors wish to thank Paul Crits-Christoph, Ph.D., University of Pennsylvania and Robert Gallop, Ph.D., West Chester University, for their assistance in combining the datasets from CTN protocol 0018 and CTN protocol 0019.

Author information

Authors and Affiliations

  1. Alcohol and Drug Abuse Institute and the Department of Psychiatry and Behavioral Sciences, University of Washington, 1107 NE 45th St., Ste. 120, Seattle, WA, 98105, USA

    Donald A. Calsyn & Mary A. Hatch-Maillette

  2. Duke University, Durham, NC, USA

    Christina S. Meade

  3. Columbia University College of Physicians & Surgeons, New York, NY, USA

    Susan Tross & Aimee N. C. Campbell

  4. School of Social Work, University of Washington, Seattle, WA, USA

    Blair Beadnell

Authors
  1. Donald A. Calsyn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mary A. Hatch-Maillette
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina S. Meade
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susan Tross
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aimee N. C. Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Blair Beadnell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donald A. Calsyn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Calsyn, D.A., Hatch-Maillette, M.A., Meade, C.S. et al. Gender Differences in Heterosexual Anal Sex Practices Among Women and Men in Substance Abuse Treatment. AIDS Behav 17, 2450–2458 (2013). https://doi.org/10.1007/s10461-012-0387-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-012-0387-7

Keywords

Search

Navigation