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Research with women who have male partners recently released from jail or prison has also yielded high rates of anal intercourse Bland et al. Results 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. In most cases, disagreements involved omissions. Informed consent was a two-stage process: 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. Due to the limited nature of previous 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. While this growing body of literature suggests that anal intercourse among heterosexual women may be more prevalent than previously assumed particularly among drug-abusing samples of women , there is currently very little information about why these women are engaging in anal intercourse. Following the recommendations of Krueger , the 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 regular , the role of alcohol and illicit substances in facilitating the anal intercourse, and other relevant characteristics of the male partners known to be bisexual, previous incarceration history and any other information the women were willing to provide concerning the anal intercourse event itself e. Harawa and Adimora linked high incarceration rates among both men and women in the African American community with HIV through a number of mechanisms, including the role incarceration plays in reducing the number of male sexual partners available to African American women.

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The riskiness of AI was assessed within relationship contexts. 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 resulting sample consisted of 32 women from diverse ethnic backgrounds: In the third phase, Dedoose was used to mark excerpts from the transcripts. In the second phase, a constant comparison method was used to group and organize the marginal codes conceptually. When these omissions were counted as disagreements, the kappa coefficient was. 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. Their model includes alcohol and drug use and high-risk steady partners who have been linked to anal intercourse. Women then answered a brief demographic questionnaire that elicited information on their age, self-reported ethnicity, and the number 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. This article has been cited by other articles in PMC. 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 second stage consent process required the women to give separate consent to have the focus group digitally recorded for later transcription and coding. 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 numbers of concurrent partners among heterosexuals Kalichman et al. 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, Past experience with AI including emotional and physical reactions was identified. Results 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. All omissions and discrepancies were then discussed by the coders, and a consensus approach was used to assign final codes. 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. The majority of AI episodes were unplanned and not discussed prior to initiation. Method Focus group methods were selected to uncover the wide range of reasons that drug-abusing women may have for engaging in heterosexual anal intercourse. Dedoose was used to assess inter-rater reliability utilizing a random selection of one-third of the excerpts created by the second author. 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. 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. Data Analysis The audio files produced by the recording equipment in MP3 format were transcribed verbatim and imported into Dedoose, an on-line qualitative analysis program that facilitates coding, sorting, and displaying mixed method data. As can be seen in Fig. Following the recommendations of Krueger , the 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 regular , the role of alcohol and illicit substances in facilitating the anal intercourse, and other relevant characteristics of the male partners known to be bisexual, previous incarceration history and any other information the women were willing to provide concerning the anal intercourse event itself e.

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