Heterosexual anal intercourse (HAI) is an understudied sexual behavior and poses unique challenges to the prevention of sexually transmitted diseases (STDs). This study aimed to explore individual and partnership characteristics associated with HAI. This study used data collected from 243 young people who attended STD clinics in Los Angeles County between April 2012 and May 2014. Participants reported on sexual behaviors with their last three sexual partners. Hierarchical, mixed effects, repeated-measures analyses were used to assess partner-level (demographic) and individual-level (demographic and behavioral) factors associated with recent (past 6 months) HAI. Thirty-two percent of participants (n = 243) reported HAI with at least one recent sex partner, and 49% reported ever having anal intercourse (AI). After adjusting for demographic characteristics, HAI was more than twice as likely to occur in relationships (n = 503) lasting more than a year compared to relationships lasting less than one month. HAI was also more likely to occur in relationships where intimate partner violence (IPV) was reported either as IPV initiated by the respondent (aOR = 2.18, 95% CI 1.08–4.41) or IPV initiated by the partner (aOR = 2.38, 95% CI 1.27–4.47). Among our participants, a substantial proportion reported HAI in the recent past 6 months and nearly half reported lifetime AI. Notably, our results indicate the importance of relationship contexts for people engaging in HAI and highlight the increased risk of STD/HIV transmission in the context of relationships with intimate partner violence victimization and perpetration.

异性恋肛交 (HAI) 是一种未被充分研究的性行为，对预防性传播疾病 (STD) 提出了独特的挑战。本研究旨在探索与 HAI 相关的个人和伙伴关系特征。这项研究使用了从 2012 年 4 月至 2014 年 5 月期间在洛杉矶县参加 STD 诊所的 243 名年轻人收集的数据。参与者报告了他们与最后三个性伴侣的性行为。使用分层、混合效应、重复测量分析来评估与最近（过去 6 个月）HAI 相关的合作伙伴级别（人口统计）和个人级别（人口统计和行为）因素。32% 的参与者 ( n = 243) 报告与至少一名近期性伴侣发生 HAI，49% 报告曾有过肛交 (AI)。在调整人口特征后，HAI 在人际关系中发生的可能性是其他人的两倍多 ( n = 503）与持续不到一个月的关系相比，持续超过一年。HAI 也更有可能发生在亲密伴侣暴力 (IPV) 报告为受访者发起的 IPV (aOR = 2.18, 95% CI 1.08–4.41) 或伴侣发起的 IPV (aOR = 2.38, 95%) 的关系中CI 1.27–4.47）。在我们的参与者中，很大一部分报告了最近 6 个月的 HAI，近一半报告了终生 AI。值得注意的是，我们的结果表明了关系背景对于参与 HAI 的人的重要性，并强调了在与亲密伴侣暴力受害和实施的关系中性传播疾病/艾滋病毒传播的风险增加。