Official websites use. Share sensitive information only on official, secure websites. Correspondence should be sent to Samuel M. Jenness supervised the study, conceptualized and conducted the analysis, and led the writing. Begier and A. Neaigus helped to conceptualize the analysis and assisted with the writing. Murrill, T. Wendel, and H. Hagan supervised the study and assisted with the writing. We examined the association between unprotected anal intercourse and sexually transmitted diseases STDs among heterosexual women.
In through , women were recruited from high-risk areas in New York City through respondent-driven sampling as part of the National HIV Behavioral Surveillance study. We used multiple logistic regression to determine the relationship between unprotected anal intercourse and HIV infection and past-year STD diagnosis. Unprotected anal intercourse was more likely among those who were aged 30 to 39 years, were homeless, were frequent drug or binge alcohol users, had an incarcerated sexual partner, had sexual partners with whom they exchanged sex for money or drugs, or had more than 5 sexual partners in the past year.
In the logistic regression, women who had unprotected anal intercourse were 2. We found no significant association between unprotected anal intercourse and HIV infection. Increased screening for history of unprotected anal intercourse and, for those who report recent unprotected anal intercourse, counseling and testing for HIV and STDs would likely reduce STD infections.
Unprotected anal intercourse is a well-described risk factor for HIV and sexually transmitted diseases STDs among men who have sex with men, 1 but fewer studies have investigated its importance as a risk factor in heterosexuals. Among at-risk heterosexuals, unprotected anal intercourse often clusters with other risk behaviors, such as illicit drug and binge alcohol use, 5 , 6 trading sex for money, 7 and having multiple sex partners.
Most heterosexuals engage in unprotected anal intercourse less frequently than they engage in unprotected vaginal intercourse, but unprotected anal intercourse presents a higher probability of HIV and STD infection than does unprotected vaginal intercourse, particularly for women. Two other often-cited studies also reported increased risk of HIV infection from anal intercourse, 15 , 16 but again did not report whether they measured protected or unprotected anal intercourse and used a broad timeframe lifetime history for these risk behaviors.
