Women had unprotected anal intercourse with a wide variety of partners, ranging from friends to casual partners, short-term and long-term boyfriends, husbands, strangers met on the Internet, and fathers of their children. In this context, male initiative alone may not necessarily indicate a lack of female agency, but rather serve as a marker for the presence of a strong sexual script that dictates male pursuit and female acquiescence or rejection of male desire. AIDS and heterosexual anal intercourse. Prevalence and correlates of anal sex with men among young adult women in an inner city minority neighborhood. Given that the need for female-controlled alternatives to condoms encompasses products that can be used intrarectally as well as vaginally, rectal microbicides should be marketed to women as well as to MSM. Following this line of reasoning, at first glance the pattern of male initiative over anal intercourse suggests that women might engage in anal intercourse under pressure, coercion, or persuasion from male partners. Journal of Acquired Immune Deficiency Syndromes. For example, engaging in an unusual practice with her casual sexual partner made one participant feel more desirable: Participants were assigned unique identifier codes, given a brief overview of the procedures, re-screened to ensure eligibility, and asked to review and sign an informed consent form. Taking sexual scripting theory into account, however, a more complex story emerges from the data. Viewed as a complementary form of sexual expression, anal intercourse took on meaning not only as a site of negotiation and pressure, but as a source of sexual pleasure and eroticism for the women in our study. Gross M, et al. Future research is needed to elucidate such relationships. A grounded theory approach guided the qualitative data analyses 29 , Or not being given much in the way of sex education. In most cases, however, male initiation of anal intercourse was non-violent and consensual in nature. Reinisch JM, et al.