Anal intercourse between men and women

Anal intercourse between men and women has generally not received as much attention as anal intercourse between men. However, there is evidence that anal sex is practised by large numbers of sexually active adults on a regular basis, and that anal intercourse plays an important role in HIV transmission amongst heterosexuals.

One quarter of heterosexual women in the United States have reported having anal intercourse occasionally, and 10% engage in it regularly. A 2004 telephone survey of heterosexuals under 35 conducted by the US Association for Social Health found that, of the approximately 7% of heterosexuals who said they had anal sex, 65% did not use condoms.

In the UK, 12.3% of male respondents and 11.3% of women who responded to the National Survey of Sexual Attitudes and Lifestyles (2000) reported anal intercourse with a partner of the opposite sex in the previous year.

In 1992 the European Study on Heterosexual Transmission of HIV highlighted anal intercourse as one of the factors which increased the likelihood of transmission amongst the couples in the study, and showed that amongst couples where the infected partner was still asymptomatic (and not likely to be highly infectious), the chance that infection was likely to have taken place through anal intercourse was five times greater than through vaginal intercourse. (Caution should be exercised when drawing conclusions from these findings, because of the small numbers involved.) Unprotected heterosexual anal sex has also been shown to be a significant route of HIV infection in Africa, especially in young men and women.^{1 2}

The risk of infection for a woman from one act of anal intercourse has been reported as 2.3 times greater than that from vaginal intercourse.³