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Anal intercourse poses a greater risk for HIV transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse HAI is not uncommon.

However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. Almost half of the sample was non-Hispanic Black. Men who reported HAI were more likely to be Hispanic, homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex.

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This research supports other work showing the relationship between HAI and high-risk behaviors. More importantly, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking.

This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions. Among specific groups of higher risk populations, the prevalence of recent HAI is also relatively high.

Most of the HAI literature has focused on women Jenness et al. However, it is also important to understand the men who engage in HAI. The few studies that have addressed this have found that HAI among men is associated with having concurrent partners, exchanging drugs or money for sex, incarceration, sex with an injection drug user, not being heterosexual, alcohol use, and substance use Gorbach, Manhart, et al. Overall, research has focused "Anal sex at the beach" demographic and behavioral correlates of HIV-risk behaviors, but there has also been some interest in personality traits that could be associated with risky behavior.

In particular there has been interest in the dynamics of sensation seeking. Kalichman developed two scales to assess this personality trait, one that addressed sexual sensation seeking and another that addressed non-sexual experience seeking Kalichman et al.

However, this study was conducted among a sample of mostly white college students, and the findings may not be true of other populations. Another study conducted in a sample of heterosexual sex-research volunteers found a positive correlation between SSS and number of anal sex partners among Asian Americans and Caucasians, but no association among Anal sex at the beach Americans Nguyen et al.

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In this study analyses were not stratified by gender. Given the limited research and discrepant results, more research is warranted on this topic. The current paper further explores the association between recent HAI and other risk behaviors as well as sensation seeking in a sample of low-socioeconomic status SES men in Long Beach, California.

This analysis focused on the men who reported having a female partner in the past 30 days, which resulted in a sample size of 1, All participants gave informed consent using a consent form approved by the California State University, Long Beach Institutional Review Board, and were administered the Risk Behavior Assessment RBA by a trained interviewer in a face-to-face interview.

The RBA gathers information on demographics, sexual behavior, and drug and alcohol use. It has been shown to have good reliability and validity Dowling-Guyer et al. Several covariates were assessed in bivariate analyses to determine their association with HAI. Sexual behavior was assessed for the previous month.

The number of partners and the frequency of vaginal intercourse were left as continuous variables, Anal sex at the beach whether or not a man reported a male sex partner was recoded to be a dichotomous variable.

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The frequency of vaginal intercourse and frequency of condom use variables were used to create a three-level variable of condom use always, inconsistent, neverwhich is more "Anal sex at the beach" with Hershberger et al.

Finally participants were asked the number of times they had been told by a health care provider that they had HIV, herpes, syphilis, gonorrhea, and Chlamydia. These were also recoded as dichotomous variables. The collection of these scales only took place between October and June The SC scale is a item, Likert-type measure that assesses the degree to which people agree with a series of statements that address compulsive sexual behavior, sexually intrusive thoughts, and sexual preoccupation.

The SSS and NES scales are each item, Likert-type measures that ask respondents to rate their agreement with statements about sensation-related thoughts and feelings. The scales were summarized by taking the mean of the scale items among the participants who are not missing more than two items, which is consistent with instructions by the author Kalichman, personal communication, October 8, Bivariate and multivariate associations were assessed using logistic regression.

Variables were considered for inclusion in the multivariate model based on a priori knowledge and significance at the bivariate level. Items were considered significant if the p -value was less than. All analyses were conducted using SAS 9.

The median age of the sample was 42 years with a range from 14 to Twenty percent of the men reported HAI in the past month. Among men who reported vaginal intercourse, the median number of acts was 5 [IQR: Men who reported inconsistent condom use during vaginal Anal sex at the beach were more likely to have had recent HAI than men who had never used condoms during vaginal intercourse, and those who always Anal sex at the beach condoms during vaginal intercourse were less likely to have had HAI Table 2.

Men who reported recent HAI also reported a higher mean number of partners in the past month and a higher frequency of vaginal intercourse than men who did not report recent HAI. The prevalence of HAI was higher among men who reported a male sex partner as well as a female sex partner in the past month compared to those who did not Table 2. The MSMW sample in our study was too small for extensive multivariate analysis, but in bivariate analyses, MSMW who had anal intercourse with a male partner in the past month were more likely to have had recent HAI than MSMW who had not had anal intercourse with a male partner insertive: Additional analyses were run on the sub-set of men who completed the sensation seeking and sexual compulsivity questionnaires.

Three multivariate analyses were then conducted. Each model contained one of the scales as well as the predictors in the original model presented in Table 3 Table 5column 2. Finally, in a model that controlled for all three of the sensation-seeking scales as well as the factors in the original model, men who were higher on the SSS scale were more likely to report recent HAI Table 5column 3.

According to Allison, Anal sex at the beach the tolerance is below. This was similar to what has been found in other studies of high-risk populations STI clinics, substance-users Ibanez et al. Much of the previous literature on HAI has focused on young heterosexuals.

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The current sample includes a wide range of ages, as well as ethnicities, and includes men of very low SES. The fact that the correlates of HAI are so stable across varying populations, lends support to the truth of these associations among high-risk populations. One factor that was bivariately significant in our data, but was not significant in the multivariate model, and, therefore, was not included in the model, was history of incarceration.

This is in contrast to other findings Javanbakht et al. The lack of "Anal sex at the beach" in our sample could have been due to the extremely high rates of incarceration in our sample. Another contribution of this paper is that the analysis also examined specific drugs used in the context of sex and not just substance use in general. In multivariate analyses, Anal sex at the beach and amphetamine use during sex were both significantly associated with HAI.

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This helps to clarify which drugs in particular may Anal sex at the beach associated with HAI instead of grouping all drugs into one summary variable. It is interesting that both drugs are stimulants. Event-level data would provide finer-grained examination of the temporality and specificity of these relationships.

These men may acquire a preference for anal, compared to vaginal, intercourse, which is manifested in their sexual encounters with both men and women. However, qualitative research in this population suggests that MSMW are unlikely to have anal intercourse with a woman Schnarrs et al.

Future research may want to further explore in more detail the motivations for anal intercourse with both men and women in an MSMW population. A major contribution of this Anal sex at the beach is that it extends previous research by also examining the association between sensation seeking and HAI.

It is not surprising that those who seek out heightened stimulation and arousal would be more likely to have recent HAI, and that those who are sexually compulsive are also more likely to have HAI. However, when potentially confounding factors are controlled for in the model, SC is no longer associated with HAI while the two sensation seeking scales remain significant. It appears that one of the key confounders that attenuate the association between SC and HAI is the number of sexual partners.

This fits in with the definition of SC, which is defined as an unwanted repetitive urge, so the sexual acts are an effort to avoid the anxiety generated by the compulsion. The sexual acts are not a result of seeking new and exciting sensations. Therefore, SC is probably more highly associated with frequency of sexual acts and not necessarily with whether or not a specific type of sexual behavior was performed at least Anal sex at the beach. The sensation seeking constructs identify people who desire new stimulation and arousal, which may be fulfilled by HAI.

Finally, when all three scales are included in the same model, the one that remains significant is the sensation seeking scale that is specific to sexual stimulation and arousal. There might be concern about multicollinearity because of the correlation between the scales, but inspection of the tolerance scores suggests that this was not the case Allison, Therefore, when SSS was included in the model there was no longer an independent effect from the unique variance of NES.

This supports other work that has found an association between sensation seeking and various risky behaviors, such as having concurrent partners and having sex under the influence of drugs or alcohol Charnigo et al. However, there have been discrepant results for HAI among heterosexuals. One study among heterosexuals found that SSS was associated with number of anal sex partners, but their emphasis was on ethnicity Nguyen et al. To our knowledge, the current study Anal sex at the beach the first study to consider the association between HAI and sensation seeking among men while controlling for other potential covariates.

The fact that men higher on SSS were more likely to have recent HAI and were less likely to use condoms during HAI suggests that sensation seekers are more willing to take risks in order to achieve heightened stimulation and arousal.

This result can be applied to the development of HIV-prevention interventions in an effort to improve their efficacy. One approach might be to emphasize novelty and arousal in HIV-prevention messages that target this group, as was suggested in previous work among MSM Kalichman et al. In recent years, this type of Anal sex at the beach has become more common in interventions that target MSM, but is still uncommon in interventions that target heterosexual men.

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This study has several limitations including the self-reported nature of the data, which is common to almost all sexual and drug behavior research. Self-report data can suffer from low reliability, however, in this case the behavior instrument has been found to have very good reliability and the validity of the drug use variables are also very good Dowling-Guyer et al.

These men could be different Anal sex at the beach other parts of the population, and therefore the results may not be generalizable. However, this population does represent an important high-risk group, and it is imperative to understand their behavior in order to provide appropriate interventions. Finally, the study did not include event-level data, so we can only approach Anal sex at the beach analysis of the context in which HAI occurred in a course-grained manner.

It would be beneficial in future research to collect event-level data. Then we could determine the exact associations and sequences of sex trading, drug use, and HAI. This study demonstrates, in a racially diverse sample of low SES men, that a substantial number of them are engaging in HAI.

Twenty percent reported HAI within the past month, which suggests that these men are practicing HAI with relatively high frequency. It Anal sex at the beach likely that if the time frame had been extended, then the number of men reporting HAI would have been even greater.

This research also makes an important contribution that highlights the need to consider personality traits when trying to understand sexual behavior and when developing those interventions.

More study is obviously needed to fully understand the context in which HAI occurs. National Center for Biotechnology InformationU. Author manuscript; available in PMC Nov 1. Author information Copyright and License information Disclaimer.

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