Marseille 2007
| Abstract #615 - Correlates of Heterosexual Anal Sex among Adolescents and Young Adults | ||||
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Session: 49.6: Late Breakers (Parallel) on Wednesday @ 08.30-10.30 in HC Chaired by Bruno Spire, Kate Hankins Authors: Presenting Author: Dr Larry Brown - Brown University / Rhode Island Hospital, United States |
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| Additional Authors: Dr Celia Lescano, Dr Christopher Houck, The SHIELD Study Group, | ||||
| Aim: Unprotected anal intercourse poses the greatest risk of acquiring HIV when contrasted to other sexual activities. Among 18-19 year-olds, 15% of males and 19% of females had done so according to the National Survey of Family Growth. There are no studies of predictors of heterosexual anal sex among youth but among adults it has been associated with substance use and other sexual risk behaviors. The primary purpose of this study was to identify demographic, behavioral, relationship context, attitudinal, substance use, and mental health variables associated with adolescent and young adult engagement in recent (last 90 days) heterosexual anal sex. | ||||
| Method / Issue: This study was conducted as part a randomized controlled trial of an HIV prevention program (Project SHIELD) conducted in three US cities. Participants were between the ages of 15 and 21 (Mean=18.2, SD=1.8) and had had unprotected vaginal or anal sex in the past 90 days. Audio computer-assisted self-interview assessed demographics, detailed sexual risk behavior for each sexual partner in the past 90 days, substance use and risk attitudes. Analyses were conducted separately by gender and all bivariate comparisons with p < .05 were entered into Multiple Logistic Regressions (MLR) predicting occurrence of heterosexual anal sex. | ||||
| Results / Comments: 16% of the 1343 subjects reported recent heterosexual anal sex (102 of 584 males and 113 of 759 females). For females, race/ethnicity, sexual orientation, living with partner, hedonism, drug influence attitudes, suicide attempt history, proportion of unprotected vaginal sex acts, number of partners, sex with someone with multiple partners, and forced sex were entered into a MLR. Those who engaged in anal sex were more significantly likely to be living with a sexual partner (OR = 1.8), had 2 or more partners (OR = 1.7), and reported having been forced to have sex (OR = 2.7) [model ChiSquare (10) =40.26, p = .000]. For males, sexual orientation, income, hedonism, perceived invulnerability to HIV, drugs/alcohol during last sex, sex with someone with multiple partners, and sex with a sex trader were entered into a MLR. Only the variable indicating sexual orientation other than heterosexual (generally bisexual or undecided) (OR = 6.4) was significantly predictive of having engaged in heterosexual anal sex [model ChiSquare (7) =27.06, p = .001]. There was also a trend for those having sex having sex with a sex trader (OR = 2.8, p = .06) to be predictive. | ||||
| Discussion: These data document the frequent occurrence of recent heterosexual anal sex among adolescents and young adults. Different influences between males and females suggest foci for interventions. Sexual risk attitudes and perception of HIV vulnerability were largely unrelated to its occurrence. However, for females, anal sex was significantly associated with variables that describe the contextual nature and power balance of the relationship with their sexual partners (eg. living with a partner or being forced to have sex). In contrast for males, sexual orientation attitudes (uncertainty of sexual orientation or a non-heterosexual orientation) was the greatest influence on heterosexual anal sex. | ||||
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