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Individual and Partnership Factors Associated with Heterosexual Anal Intercourse Among Attendees of Public Sexually Transmitted Disease Clinics in Los Angeles County

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Abstract

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.

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Acknowledgements

This work was completed by Dr. Westmoreland at the University of California, Los Angeles. Dr. Westmoreland’s current institution is the Institute for Implementation Science in Population Health at the City University of New York, New York, NY.

Funding

This research was supported by the National Institutes of Health/National Institutes of Allergy and Infectious Diseases (Grant No. K01AI091861).

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Authors and Affiliations

  1. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Drew A. Westmoreland, Pamina Gorbach, Onyebuchi A. Arah & Marjan Javanbakht

  2. Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Pamina Gorbach

  3. Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA

    Ian W. Holloway

  4. Institute for Implementation Science in Population Health, City University of New York, 55 West 125th Street, Room 626, New York, NY, 10027, USA

    Drew A. Westmoreland

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  1. Drew A. Westmoreland
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  2. Pamina Gorbach
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  3. Ian W. Holloway
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  4. Onyebuchi A. Arah
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  5. Marjan Javanbakht
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Correspondence to Drew A. Westmoreland.

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Participants provided written informed consent prior to enrollment. The study was approved by the Institutional Review Board at the University of California Los Angeles and the Los Angeles County Department of Public Health.

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Westmoreland, D.A., Gorbach, P., Holloway, I.W. et al. Individual and Partnership Factors Associated with Heterosexual Anal Intercourse Among Attendees of Public Sexually Transmitted Disease Clinics in Los Angeles County. Arch Sex Behav 50, 347–358 (2021). https://doi.org/10.1007/s10508-020-01831-7

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