Background
Substance abusers are at risk for HIV and other STIs.
Anal intercourse (AI) is riskier than vaginal intercourse.
Studies of AI have focused primarily on men who have sex withmen (MSM). However, recent national surveys indicate that the totalacts of AI occur more frequently among heterosexuals than amongMSM.
Little has been reported about heterosexual anal intercourse (HAI)among men and women substance abusers.
HAI is riskier for women than men because they are always thereceptive partner.
Conclusions
More men and women in substance abuse treatment practiceHAI than in the general population.
Men engage in HAI more with casual partners than do women.
Condom use for HAI is infrequent.
Younger age, bisexual behavior, being White and having moresex partners (men) were associated with engaging in HAI.
An increased focus on HAI in HIV prevention efforts with menand women in substance abuse treatment is warranted.
Acknowledgements
This study was supported by National Institute on Drug Abuse (NIDA) grantsU10 DA13714 (Dennis Donovan , PI), U10 DA 13035 (Edward Nunes, PI), U10 DA013727 (Kathleen Brady, PI).
The authors wish to thank Paul Crits-Christoph, Ph.D., University ofPennsylvania and Robert Gallop, Ph.D., West Chester University, for theirassistance in combining the datasets from CTN protocols 0018/0019.
No conflict of interests to report.
Gender differences of heterosexual anal sex among men
and women in substance abuse treatment
Donald A. Calsyn, Ph.D.1,2, Mary A. Hatch-Maillette, Ph.D.1,2, Christina S. Meade, Ph.D. 3, Susan Tross, Ph.D.4, Aimee N. C. Campbell, Ph.D.4
1Alcohol & Drug Abuse Institute, 2Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, 3Duke University, Durham, NC, 4 Columbia University College of Physicians & Surgeons, New York, NY
Methods
Participants were men (n=539) and women(n=421) enrolled in the NIDA Clinical TrialsNetwork (CTN) “Real Men Are Safe” and “SafeSex Skill Building for Women” trials whoreported heterosexual activity at baseline.
A logistic regression model with HAI as the DVincluded variables related to high risk sex, andparticipant sex as an interaction term.
Results – Condom Use
Men more likely than women to usecondoms for HAI with main partners (21.9%vs. 9%, Χ2=5.60, p = .02, Figure 3).
No gender difference in condom use forHAI with casual partners (Figure 3).
No differences in
Percent of total sexual intercourse events that were HAI (Median=16.67 menvs. 13.04 women).
Percent who engaged in HAI with their main sexual partner. (Figure 2).
Percent of men (4.3%) and women (6.8%) reporting bisexual activity in theprior 90 days.
For men and women,recent bisexualbehavior, and beingyounger and white,were significantlyassociated with HAI.
For men, number ofsex partners was alsoassociated with HAI.
Figure 1
Figure 2
Figure 3
Table 1
Specific Aims
Compare the prevalence of HAI among men and womenin substance abuse treatment to data from nationallyrepresentative sample of U.S. adults.
Compare rates of HAI with main and casual partnersamong men and women substance abusers in treatment
Identify variables associated with HAI among substanceabusers.
Results – HAI Frequency
Compared to the general population (NationalSurvey of Sexual Health and Behavior ), more maleand female substance abusers engaged in HAI (seeFigure 1).
Among male and female substance users:
More men (32.8%) than women (27.1%) engage inHAI (Χ2=3.7, p = .47, Figure 1).
HAI with casual partners more likely in men(Figure 2).
Of men (n=65) and women (n=37) with both mainand casual partners and who engaged in HAI, men(56.9%) were more likely than women to engage inHAI with both main and casual partners (17.6%,Χ2=14.0, p < .001).
More bisexual men (52.2%) and women (46.7%)reported HAI in the prior 90 days than heterosexual-only men (32.0%, Χ2=4.07, p=.04) and women(25.5%, Χ2=6.33, p = .01).
Results – Logistic Regression
Logistic regression summary identifying variables
associated with heterosexual anal intercourse (n=945).
