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This study used qualitative methods to assess why women engage in heterosexual anal receptive intercourse AI with a male partner. Four focus groups which comprised women from diverse ethnicities were conducted. All groups were digitally recorded for transcription; transcripts were analyzed using the methods of grounded theory to determine themes.

The riskiness of AI was assessed within relationship contexts. Past experience with AI including Anal women over 45 and physical reactions was identified. Among the negative physical experiences of AI were pain and disliking the sensation, and uncomfortable side effects, such as bleeding of the rectum. Negative emotional experiences of AI included feelings of shame, disgust, and being offended by something her male partner did, such as spitting on his penis for lubrication.

Positive physical experiences included liking the sensation.

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Many of the women also endorsed positive emotional experiences of AI, including that it was more intimate than vaginal sex, and that it was something they reserved only for special partners. The majority of AI episodes were unplanned and not discussed prior to initiation. Pain during AI was mitigated by the use of lubricants or illicit drugs. Even those women who found pleasure in AI expressed a preference for vaginal intercourse.

Recent interest in heterosexual anal intercourse has been generated from several research perspectives. In the United States, general population surveys have suggested that the prevalence of anal intercourse among heterosexuals has increased over time Leichliter, Interest in anal intercourse has also come from research in human immunodeficiency virus HIV transmission. Several studies have quantified the increased risk of heterosexual transmission from one act of anal intercourse as compared to one act of vaginal intercourse Boily et al.

The increased risk of HIV transmission through anal intercourse has been well documented in studies of homosexual and bisexual men; however, there has only recently been interest in documenting comparable risks among heterosexual samples.

The studies that have used heterosexual samples have generally focused on parts of the world, such as South Africa, that have not only high rates of anal intercourse among heterosexuals, but also high HIV prevalence in the general population and high numbers of concurrent partners among heterosexuals Kalichman et al.

Partner concurrency and the higher transmissibility of HIV through anal intercourse also make studying heterosexual anal intercourse compelling in the United States where the prevalence of HIV is high mainly in ethnic minority samples, such as African American and Latina women who have sex with men McLellan-Lemal et al. According to the U. Research with women who have male partners recently released from jail or prison has also yielded high rates of anal intercourse Bland et al.

Harawa and Adimora linked high incarceration rates among both men and women in the African American community with HIV through a number of mechanisms, including the role incarceration plays in reducing the number of male sexual partners available to African American women.

There is also research literature on heterosexual anal intercourse among drug-using subsamples, which has found a relationship between anal intercourse and both injection and non-injection drug use Bogart et al. While this growing body of literature suggests that anal intercourse among heterosexual women may be more prevalent than previously assumed particularly among drug-abusing samples of womenthere is currently very little information about why these women are engaging in anal intercourse.

Bandura stated that human behavior is learned from watching and interacting with Anal women over 45 human beings. Women may learn about anal intercourse through male sex partners, and then they may suggest anal intercourse with new sex partners for a variety of reasons, including a desire to be responsive to his desires or because she has learned to like anal intercourse from the experience with a previous sex partner.

Through these traditional gender roles and sexual scripts e. Gender and power theory, which focuses on the sexual division of labor, sexual division of power, and social norms associated with relationships between men and women, may also inform our understanding of heterosexual anal intercourse Connell, Their model includes alcohol and drug use and high-risk steady partners who have been linked to anal intercourse.

The current study sought to examine why heterosexual women engage in anal intercourse. Due to the limited nature of previous research on this topic, we opted for a more exploratory approach aimed at uncovering the broad range of "Anal women over 45" that women had for engaging in anal intercourse. Focus group methods were selected to uncover the wide range of reasons that drug-abusing women may have for engaging in heterosexual anal intercourse.

Focus groups are particularly well suited for uncovering a full range of opinions, experiences, or concerns about Anal women over 45 topic Krueger, Focus groups were also preferred by the participating outpatient drug treatment program because participants were familiar with group activities and settings.

The majority had participated in some form of outpatient drug treatment, but some of the women had never received Anal women over 45 treatment for their drug use. Further questioning revealed that all of the participants had had anal intercourse, but some did not count it as such if the man did not ejaculate or if the woman insisted he withdraw because of pain.

The resulting sample consisted of 32 women from Anal women over 45 ethnic backgrounds: Following the recommendations of Kruegereach focus group consisted of 7—10 participants, and all focus groups were conducted by the first author who has experience with group facilitation and has worked extensively with the population served at both the drug treatment center and CBRS. The focus groups were constituted so that all the women in each group were of the same ethnicity; group 1 was African American, group 2 was Latina, and group 3 was White, but group 4 was mixed with approximately equal proportions of African American and White women.

Upon arrival at the focus group location, participants were first informed about the nature of the study and all associated risks and benefits.

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