Receptive anal sex is associated with HIV seropositivity in women

Background Anal sex is a high-risk HIV behavior in men who have sex with men, but less is known about its role in HIV risk for women. Methods 829 women, of whom 193 (23%) reported heterosexual receptive anal intercourse (HRAI), completed several behavioral measures in addition to receiving human immunodeficiency virus (HIV), hepatitis, and sexually transmitted infection (STI) testing. The study population was recruited in Long Beach, California, and was ethnically and racially diverse. Measures included the Risk Behavior Assessment, Sexual Sensation-Seeking Scale, Sexual Compulsivity Scale and Nonsexual Experience-Seeking Scale (SSS-SC-NES); the Barratt Impulsivity Scale (BIS), the Women's Sexual Addiction Screening Test (w-SAST), the Eysenck Impulsivity Scale (EIS), and the Compulsive Sexual Behavior Inventory (CSBI). Results HIV prevalence was higher in women reporting HRAI than in women not reporting HRAI (Χ²(619) = 4.67, p = .03). Women who reported HRAI had higher mean number of days using alcohol, crack, powdered cocaine, heroin, speedball and amphetamine, higher mean number of lifetime arrests and were more likely to have been in drug treatment compared to non HRAI women. Women who reported HRAI had higher mean scores on the SSS-SC-NES, BIS, EIS, w-SAST, and CSBI compared to women who did not report HRAI. Conclusions Women are not adequately knowledgeable about the risks associated with receptive anal sex and public health should address HRAI in education, prevention, and HIV/STI testing efforts with women. Issues such as sexual sensation-seeking, compulsivity and sex addiction also need to be addressed in prevention efforts with women.