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Anal sex practices in heterosexual and male homosexual populations: a review of population-based data

Wendy Heywood A and Anthony M. A. Smith A B
+ Author Affiliations
- Author Affiliations

A Australian Research Centre in Sex, Health & Society (ARCSHS), La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia.

B Corresponding author. Email: anthony.smith@latrobe.edu.au

Sexual Health 9(6) 517-526 https://doi.org/10.1071/SH12014
Submitted: 1 February 2012  Accepted: 19 March 2012   Published: 6 July 2012

Abstract

Anal sex is known to be an important risk factor for anal cancer. Yet compared with vaginal intercourse, little is known about anal sex practices in either heterosexual or male homosexual populations. Of the data that are available, it appears a significant and increasing minority of heterosexuals have ever practised anal intercourse. Among homosexual men, most, but not all, report anal sex, with large proportions of men engaging in both insertive and receptive anal intercourse. The most significant finding of the review was the dearth of population-based data, particularly relating to homosexual men.

Additional keywords: intercourse, men, MSM, women.


References

[1]  Barroso LF, Wilkin T. Human papillomavirus vaccination in males: the state of the science. Curr Infect Dis Rep 2011; 13 175–181.
Human papillomavirus vaccination in males: the state of the science.CrossRef | 21365381PubMed |

[2]  Castor MG, da Silva HJ, Gondim Martins DB, de Mello RJV. HPV and precancerous lesions of anal canal in women: systematic review. Int J Colorectal Dis 2011; 27 1–6.

[3]  Hartwig S, Syrjänen S, Dominiak-Felden G, Brotons M, Castellsague X. Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe. BMC Cancer 2012; 12 30
Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe.CrossRef | 22260541PubMed |

[4]  Henquet C. Anogenital malignancies and pre-malignancies. J Eur Acad Dermatol Venereol 2011; 25 885–95.
Anogenital malignancies and pre-malignancies.CrossRef | 1:STN:280:DC%2BC3Mnms1entQ%3D%3D&md5=b55ebac35167ca0becd376db6ae1af32CAS | 21272092PubMed |

[5]  Stanley M. Pathology and epidemiology of HPV infection in females. Gynecol Oncol 2010; 117 S5–10.
Pathology and epidemiology of HPV infection in females.CrossRef | 20304221PubMed |

[6]  Voeller B. AIDS and heterosexual anal intercourse. Arch Sex Behav 1991; 20 233–76.
AIDS and heterosexual anal intercourse.CrossRef | 1:STN:280:DyaK3M3ot1KmtA%3D%3D&md5=8e116fb0930ac1c0842f4e6e5901272eCAS | 2059146PubMed |

[7]  Halperin DT. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I. AIDS Patient Care STDS 1999; 13 717–30.
Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I.CrossRef | 1:STN:280:DC%2BD3c3gsl2gug%3D%3D&md5=d6bd73f6ee7123e461f2277462d519a1CAS | 10743535PubMed |

[8]  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.
Heterosexual anal intercourse, health risks and drug use: a review with special attention to drug users.CrossRef | 1:STN:280:DC%2BD2MrivVyltQ%3D%3D&md5=d75a54a47aeba60df1cfc0a947fe7a58CAS | 16203314PubMed |

[9]  Hubert M, Bajos N, Sandfort T. Sexual behaviour and HIV/AIDS in Europe: comparisons of national surveys. London: University College London Press; 1998.

[10]  Smith G. Heterosexual and homosexual anal intercourse: an international perspective. Venereology 2001; 14 28–37.

[11]  McBride KR, Fortenberry JD. Heterosexual anal sexuality and anal sex behaviors: a review. J Sex Res 2010; 47 123–36.
Heterosexual anal sexuality and anal sex behaviors: a review.CrossRef | 20358456PubMed |

[12]  Petersen JL, Hyde JS. A meta-analytic review of research on gender differences in sexuality, 1993–2007. Psychol Bull 2010; 136 21–38.
A meta-analytic review of research on gender differences in sexuality, 1993–2007.CrossRef | 20063924PubMed |

[13]  Manhart LE, Koutsky LA. Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia?: A meta-analysis. Sex Transm Dis 2002; 29 725–35.
Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia?: A meta-analysis.CrossRef | 12438912PubMed |

[14]  Gates GJ, Sonenstein FL. Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Fam Plann Perspect 2000; 32 295–7, 304.
Heterosexual genital sexual activity among adolescent males: 1988 and 1995.CrossRef | 1:STN:280:DC%2BD3M7jslOisw%3D%3D&md5=20ca8118e7acc6890e54f2885c325e5fCAS | 11138866PubMed |

[15]  Chandra A, Mosher WD, Copen C, Sionean C. Sexual behavior, sexual attraction, and sexual identity in the United States: data from the 2006–2008 National Survey of Family Growth. Natl Health Stat Report 2011; 36 1–36.
| 21560887PubMed |

[16]  Mosher WD, Chandra A, Jones J. Sexual behavior and selected health measures: men and women 15–44 years of age, United States, 2002. Advance data from vital and health statistics; no 362. Hyattsville: National Center for Health Statistics. 2005: 1–55.

[17]  Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behavior in the United States: results from a national probability sample of men and women ages 14–94. J Sex Med 2010; 7 255–65.
Sexual behavior in the United States: results from a national probability sample of men and women ages 14–94.CrossRef | 21029383PubMed |

[18]  Johnson AM, Mercer CH, Erens B, Copas AJ, McManus S, Wellings K, et al Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet 2001; 358 1835–42.
Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours.CrossRef | 1:STN:280:DC%2BD3MjgtVCmtw%3D%3D&md5=67fb9695b7634672e4bbfc7e25710742CAS | 11741621PubMed |

[19]  Bajos N, Bozon M, Beltzer N, Laborde C, Andro A, Ferrand M, et al Changes in sexual behaviours: from secular trends to public health policies. AIDS 2010; 24 1185–91.
Changes in sexual behaviours: from secular trends to public health policies.CrossRef | 20299962PubMed |

[20]  de Visser RO, Smith AMA, Rissel CE, Richters J, Grulich AE. Sex in Australia: heterosexual experience and recent heterosexual encounters among a representative sample of adults. Aust N Z J Public Health 2003; 27 146–54.
Sex in Australia: heterosexual experience and recent heterosexual encounters among a representative sample of adults.CrossRef | 14696705PubMed |

[21]  Jung M, Choi M. The sociodemographic characteristics of concurrent sexual partnerships and their risky sexual behaviors: results of a nationally representative sample of South Korean adults. Sex Disabil 2009; 27 127–38.
The sociodemographic characteristics of concurrent sexual partnerships and their risky sexual behaviors: results of a nationally representative sample of South Korean adults.CrossRef |

[22]  Lane T, Pettifor A, Pascoe S, Fiamma A, Rees H. Heterosexual anal intercourse increases risk of HIV infection among young South African men. AIDS 2006; 20 123–5.
Heterosexual anal intercourse increases risk of HIV infection among young South African men.CrossRef | 16327330PubMed |

[23]  Stulhofer A, Bacak V. Is anal sex a marker for sexual risk-taking? Results from a population-based study of young Croatian adults. Sex Health 2011; 8 384–9.
Is anal sex a marker for sexual risk-taking? Results from a population-based study of young Croatian adults.CrossRef | 21851780PubMed |

[24]  Celentano DD, Valleroy LA, Sifakis F, Mackellar DA, Hylton J, Thiede H, et al Associations between substance use and sexual risk among very young men who have sex with men. Sex Transm Dis 2006; 33 265–71.
| 16434886PubMed |

[25]  Lindley LL, Nicholson TJ, Kerby MB, Lu N. HIV/STI associated risk behaviors among self-identified lesbian, gay, bisexual, and transgender college students in the United States. AIDS Educ Prev 2003; 15 413–29.
HIV/STI associated risk behaviors among self-identified lesbian, gay, bisexual, and transgender college students in the United States.CrossRef | 14626464PubMed |

[26]  Menza TW, Kerani RP, Handsfield HH, Golden MR. Stable sexual risk behavior in a rapidly changing risk environment: findings from population-based surveys of men who have sex with men in Seattle, Washington, 2003–2006. AIDS Behav 2011; 15 319–29.
Stable sexual risk behavior in a rapidly changing risk environment: findings from population-based surveys of men who have sex with men in Seattle, Washington, 2003–2006.CrossRef | 19830542PubMed |

[27]  Mercer CH, Fenton KA, Copas AJ, Wellings K, Erens B, McManus S, et al Increasing prevalence of male homosexual partnerships and practices in Britain 1990–2000: evidence from national probability surveys. AIDS 2004; 18 1453–8.
Increasing prevalence of male homosexual partnerships and practices in Britain 1990–2000: evidence from national probability surveys.CrossRef | 15199322PubMed |

[28]  Evans AR, Wiggins RD, Mercer CH, Bolding GJ, Elford J. Men who have sex with men in Great Britain: comparison of a self-selected internet sample with a national probability sample. Sex Transm Infect 2007; 83 200–5.
Men who have sex with men in Great Britain: comparison of a self-selected internet sample with a national probability sample.CrossRef | 17135330PubMed |

[29]  Hickson F, Bourne A, Weatherburn P, Reid D, Jessup K, Hammond G. Tactical dangers: findings from the United Kingdom Gay Men’s Sex Survey 2008. London: Sigma Research; 2010. Available online at: http://www.sigmaresearch.org.uk/go.php?/reports/report2010b [verified 24 January 2012].

[30]  Moreau-Gruet F, Dubois-Arber F, Jeannin A. Long-term HIV/AIDS-related prevention behaviours among men having sex with men: Switzerland 1992–2000. AIDS Care 2006; 18 35–43.
Long-term HIV/AIDS-related prevention behaviours among men having sex with men: Switzerland 1992–2000.CrossRef | 1:STN:280:DC%2BD2Mngt1Knsw%3D%3D&md5=edb67f2a6436fbde82d2374e11ad0dc3CAS | 16282074PubMed |

[31]  Grulich AE, de Visser RO, Smith AMA, Rissel CE, Richters J. Sex in Australia: homosexual experience and recent homosexual encounters. Aust N Z J Public Health 2003; 27 155–63.
Sex in Australia: homosexual experience and recent homosexual encounters.CrossRef | 14696706PubMed |

[32]  Lyons A, Pitts M, Smith G, Grierson J, Smith A, McNally S, et al Versatility and HIV vulnerability: investigating the proportion of Australian gay men having both insertive and receptive anal intercourse. J Sex Med 2011; 8 2164–71.
Versatility and HIV vulnerability: investigating the proportion of Australian gay men having both insertive and receptive anal intercourse.CrossRef | 21269403PubMed |

[33]  Hull P, Holt M, Mao L, Freijah R, Comfort J, Laing S, et al. Gay Community Periodic Survey: Perth 2010. Sydney: National Centre for HIV Social Research, The University of New South Wales; 2011. Available online at: http://nchsr.arts.unsw.edu.au/publications/ [verified 12 March 2012].

[34]  Lee E, Holt M, Zablotska I, Prestage G, Mills D, Blattman D, et al. Gay Community Periodic Survey: Canberra 2009. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2010. Available online at: http://nchsr.arts.unsw.edu.au/publications/ [verified 12 March 2012].

[35]  Lee E, Holt M, Mao L, Wanganeen K, Dinnison S, Williams S, et al. Gay Community Periodic Survey: Adelaide 2011. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2012. Available online at: http://nchsr.arts.unsw.edu.au/publications/ [verified 12 March 2012].

[36]  Lee E, Holt M, Mao L, Prestage G, Zablotska I, Spratling T. et al. Gay Community Periodic Survey: Queensland 2011. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2011. Available at http://nchsr.arts.unsw.edu.au/publications/

[37]  Hull P, Holt M, Mao L, Kao S, Prestage G, Zablotska I. et al. Gay Community Periodic Survey: Sydney February 2011. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2011. Available at http://nchsr.arts.unsw.edu.au/publications/

[38]  Lee E, Holt M, Mao L, McKenzie T, Batrouney C, Kennedy M, et al. Gay Community Periodic Survey: Melbourne 2011. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2011. Available online at: http://nchsr.arts.unsw.edu.au/publications/ [verified 12 March 2012].

[39]  Saxton P, Dickson N, Hughes A. GAPSS 2008: findings from the Gay Auckland Periodic Sex Survey. Auckland: New Zealand AIDS Foundation; 2010. Available online at: http://www.nzaf.org.nz/files/100928web_ready.pdf [verified 23 January 2012].

[40]  Lau JT, Siah PC. Behavioural surveillance of sexually-related risk behaviours of the Chinese male general population in Hong Kong: a benchmark study. AIDS Care 2001; 13 221–32.
Behavioural surveillance of sexually-related risk behaviours of the Chinese male general population in Hong Kong: a benchmark study.CrossRef | 1:STN:280:DC%2BD3MzisFWqsw%3D%3D&md5=032de7201aafd85d479620fa89664555CAS | 11304428PubMed |

[41]  Lau JTF, Kim JH, Lau M, Tsui HY. HIV related behaviours and attitudes among Chinese men who have sex with men in Hong Kong: a population based study. Sex Transm Infect 2004; 80 459–65.
HIV related behaviours and attitudes among Chinese men who have sex with men in Hong Kong: a population based study.CrossRef | 1:STN:280:DC%2BD2crpvFGksA%3D%3D&md5=274b3d28412f5364cb78e573e13c51dcCAS |

[42]  Li A, Varangrat A, Wimonsate W, Chemnasiri T, Sinthuwattanawibool C, Phanuphak P, et al Sexual behavior and risk factors for HIV infection among homosexual and bisexual men in Thailand. AIDS Behav 2009; 13 318–27.
Sexual behavior and risk factors for HIV infection among homosexual and bisexual men in Thailand.CrossRef | 18758936PubMed |

[43]  Fenton KA, Johnson AM, McManus S, Erens B. Measuring sexual behaviour: methodological challenges in survey research. Sex Transm Infect 2001; 77 84–92.
Measuring sexual behaviour: methodological challenges in survey research.CrossRef | 1:STN:280:DC%2BD3M3gtVyhsA%3D%3D&md5=29e83ac384115596ea768465cc00e12aCAS | 11287683PubMed |

[44]  Smith AMA, Rissel CE, Richters J, Grulich AE, de Visser RO. Sex in Australia: the rationale and methods of the Australian Study of Health and Relationships. Aust N Z J Public Health 2003; 27 106–17.
Sex in Australia: the rationale and methods of the Australian Study of Health and Relationships.CrossRef |

[45]  Marcell AV, Bell DL, Lindberg LD, Takruri A. Prevalence of sexually transmitted infection/human immunodeficiency virus counseling services received by teen males, 1995–2002. J Adolesc Health 2010; 46 553–9.
Prevalence of sexually transmitted infection/human immunodeficiency virus counseling services received by teen males, 1995–2002.CrossRef | 20472212PubMed |

[46]  Lindberg LD, Jones R, Santelli JS. Noncoital sexual activities among adolescents. J Adolesc Health 2008; 43 231–8.
Noncoital sexual activities among adolescents.CrossRef | 18710677PubMed |

[47]  Leichliter JS, Chandra A, Liddon N, Fenton KA, Aral SO. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States. J Infect Dis 2007; 196 1852–9.
Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States.CrossRef | 18190267PubMed |

[48]  Dodge B, Reece M, Herbenick D, Schick V, Sanders SA, Fortenberry JD. Sexual health among U.S. black and Hispanic men and women: a nationally representative study. J Sex Med 2010; 7 330–45.
Sexual health among U.S. black and Hispanic men and women: a nationally representative study.CrossRef | 21029389PubMed |

[49]  Fortenberry JD, Schick V, Herbenick D, Sanders SA, Dodge B, Reece M. Sexual behaviors and condom use at last vaginal intercourse: a national sample of adolescents ages 14 to 17 years. J Sex Med 2010; 7 305–14.
Sexual behaviors and condom use at last vaginal intercourse: a national sample of adolescents ages 14 to 17 years.CrossRef | 21029387PubMed |

[50]  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 Sex Med 2010; 7 277–90.
Sexual behaviors, relationships, and perceived health status among adult women in the United States: results from a national probability sample.CrossRef | 21029385PubMed |

[51]  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 Sex Med 2010; 7 291–304.
Sexual behaviors, relationships, and perceived health among adult men in the United States: results from a national probability sample.CrossRef | 21029386PubMed |

[52]  Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, Fortenberry JD. Condom use rates in a national probability sample of males and females ages 14 to 94 in the United States. J Sex Med 2010; 7 266–76.
Condom use rates in a national probability sample of males and females ages 14 to 94 in the United States.CrossRef | 21029384PubMed |

[53]  Valleroy LA, MacKellar DA, Karon JM, Rosen DH, McFarland W, Shehan DA, et al HIV prevalence and associated risks in young men who have sex with men. Young Men’s Survey Study Group. JAMA 2000; 284 198–204.
HIV prevalence and associated risks in young men who have sex with men. Young Men’s Survey Study Group.CrossRef | 1:STN:280:DC%2BD3czkvFGkug%3D%3D&md5=24749c0717e58f2f61b08a3071866a1eCAS | 10889593PubMed |

[54]  van Griensven F, Varangrat A, Wimonsate W, Tanpradech S, Kladsawad K, Chemnasiri T, et al Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003–2007. J Acquir Immune Defic yndr 2010; 53 234–9.
Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003–2007.CrossRef |



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