Condom use and anal intercourse in heterosexual men and women

Background: Condom use is less common for anal than for vaginal sex even though the associated risk for HIV transmission is higher. This study explored characteristics of condom use in a sample of heterosexual adults who reported having had both vaginal and anal intercourse and compared them to adults who reported vaginal sex only. Methods: A sample of 2235 men and 3397 women (age „d 18) who self-identified as heterosexual completed a web-based survey. Analyses were limited to those reporting lifetime sexual activity. Results: 29% of men and 26% of women reported at least one instance of heterosexual anal intercourse within the past year. Participants who reported heterosexual anal sex had a higher number of sex partners in the past year (p < .001), more occasions of unprotected sex in the past three years (p < .001), and more lifetime one night stands (p < .001) than those who reported vaginal intercourse only. Both men and women reported using condoms less frequently for anal than for vaginal sex (p < .001). Condom use during both anal and vaginal sex was associated with higher age, lower number of partners, and higher sexual inhibition. Conclusions: The findings indicate that individuals who practice anal sex also participate in other high risk sexual behaviors and report lower rates of condom use for anal than for vaginal sex. Because anal sex is associated with higher risk for disease transmission, further research on the determinants of condom use during anal sex in heterosexuals is needed.