Promoting safer sex in the context of heterosexual anal intercourse: A scoping review

doi:10.1111/jocn.15628

. 2021 Aug;30(15-16):2111-2130.

doi: 10.1111/jocn.15628. Epub 2021 Jun 13.

Promoting safer sex in the context of heterosexual anal intercourse: A scoping review

Joanne Stewart¹, Gillian Douglas², Tammy O'Rourke³, Carolyn Gammel⁴

Affiliations

¹ College and Community Health Centre, Alberta Health Services, Grande Prairie, AB, Canada.
² Beaverlodge Community Health Services, Alberta Health Services, Beaverlodge, AB, Canada.
³ Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.
⁴ Grande Prairie College & Community Health Centre, Alberta Health Services, Grande Prairie, AB, Canada.

PMID: 33377555
DOI: 10.1111/jocn.15628

Promoting safer sex in the context of heterosexual anal intercourse: A scoping review

Joanne Stewart et al. J Clin Nurs. 2021 Aug.

. 2021 Aug;30(15-16):2111-2130.

doi: 10.1111/jocn.15628. Epub 2021 Jun 13.

Authors

Joanne Stewart¹, Gillian Douglas², Tammy O'Rourke³, Carolyn Gammel⁴

Affiliations

¹ College and Community Health Centre, Alberta Health Services, Grande Prairie, AB, Canada.
² Beaverlodge Community Health Services, Alberta Health Services, Beaverlodge, AB, Canada.
³ Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.
⁴ Grande Prairie College & Community Health Centre, Alberta Health Services, Grande Prairie, AB, Canada.

PMID: 33377555
DOI: 10.1111/jocn.15628

Abstract

Aims and objectives: To locate and summarise existing literature regarding safer sex practices specific to heterosexual anal intercourse and identify promising health promotion strategies.

Background: Much of the literature regarding anal intercourse and safer sex is related to men who have sex with men. However, some studies suggest there are more women than men engaging in unprotected receptive anal intercourse. The risks associated with this sexual practice have been well documented, although many healthcare providers fail to ask about anal intercourse while addressing safer sex in the heterosexual population.

Design: The study was based on Arksey and O'Malley's 2005 five-step methodology.

Methods: A search was conducted of MEDLINE; CINAHL; PsycInfo; Cochrane; and PubMed. Databases were searched from 1990-2020. The 72 studies selected were classified according to their main area of focus. A grey literature search was also included. This scientific submission has been assessed for accuracy and completeness using the PRISMA-ScR guideline criteria (File S1).

Results: The literature in this area is heterogeneous in terms of method and topic. Prevalence and incidence (n = 26) in addition to sexually transmitted infection risks (n = 26) related to heterosexual anal intercourse are well understood. However, there is limited information on condom use (n = 6), factors that influence heterosexual anal intercourse (n = 10) and health promotion strategies for this population and practice (n = 4). Two websites that mentioned heterosexual anal intercourse risk reduction activities were included.

Conclusions: Although heterosexual anal intercourse appears to be an increasingly common sexual practice, very little is known about health promotion strategies nurses might use for encouraging safer sex in this population.

Relevance to clinical practice: Increased awareness of the prevalence and risks of heterosexual anal intercourse could enhance nurses' harm reduction strategies. Screening for sexually transmitted infections may be based on incorrect assumptions about sexual practices or due to stigma linked with anal intercourse. Reducing unprotected heterosexual anal intercourse will reduce sexually transmitted infections and their long-term sequelae.

Keywords: anal intercourse; anal sex; heterosexual anal intercourse; safer sex; scoping review.

PubMed Disclaimer

Cited by

Neuroaffective Processing of Sexually Relevant Images in Hetero- and Homosexual Women and Men: Subjective, Pupillometric, and Magnetoencephalographic Correlates.
Prantner S, Espino-Payá A, Pastor MC, Giménez-García C, Ballester-Arnal R, Junghoefer M. Prantner S, et al. Psychophysiology. 2025 Jul;62(7):e70096. doi: 10.1111/psyp.70096. Psychophysiology. 2025. PMID: 40702879 Free PMC article.
Risk factors and provider awareness of sexually transmitted enteric pathogens among men who have sex with men.
Miller TI, Banning S, Lieberman JA. Miller TI, et al. Microbiol Spectr. 2024 Apr 2;12(4):e0357723. doi: 10.1128/spectrum.03577-23. Epub 2024 Feb 23. Microbiol Spectr. 2024. PMID: 38391230 Free PMC article.
The Penis, the Vagina and HIV Risk: Key Differences (Aside from the Obvious).
Kaul R, Liu CM, Park DE, Galiwango RM, Tobian AAR, Prodger JL. Kaul R, et al. Viruses. 2022 May 27;14(6):1164. doi: 10.3390/v14061164. Viruses. 2022. PMID: 35746636 Free PMC article. Review.
Changes in Oral and Anal Sex With Opposite-Sex Partners Among Sexually Active Females and Males Aged 15 to 44 Years in the United States: National Survey of Family Growth, 2011-2019.
Katz DA, Copen CE, Haderxhanaj LT, Hogben M, Goodreau SM, Spicknall IH, Hamilton DT. Katz DA, et al. Sex Transm Dis. 2023 Nov 1;50(11):713-719. doi: 10.1097/OLQ.0000000000001867. Epub 2023 Sep 11. Sex Transm Dis. 2023. PMID: 37732840 Free PMC article.
[Sexual behavior and prevention of sexually transmitted infections taking the SARS-CoV-2 pandemic into account. Data from a sexual healthcare and medicine center-WIR].
Brockmeyer NH, Potthoff A, Knebel-Brockmeyer W, Köhler B, Nambiar S, Wach J, Rodrigues Martins T, Uhrmacher M, Schuppe AK, Tiemann C, Kasper A, Basilowski M, Kayser A, Skaletz-Rorowski A. Brockmeyer NH, et al. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 Nov;64(11):1440-1451. doi: 10.1007/s00103-021-03441-7. Epub 2021 Oct 19. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021. PMID: 34665268 Free PMC article. German.

References

REFERENCES

1. Aral, S. O., Patel, D. A., Holmes, K. K., & Foxman, B. (2005). Temporal trends in sexual behaviors and sexually transmitted disease history among 18- to 39-year-old Seattle, Washington, residents: Results of random digit-dial surveys. Sexually Transmitted Diseases, 32(11), 710-717.
1. Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological Framework. International Journal of Social Research Methodology, 8(1), 19-32.
1. Baggaley, R. F., Dimitrov, D., Owen, B. N., Pickles, M., Butler, A. R., Masse, B., & Boily, M. C. (2013). Heterosexual anal intercourse: A neglected risk factor for HIV? American Journal of Reproductive Immunology, 69(SUPPL.1), 95-105.
1. Baggaley, R. F., White, R. G., & Boily, M. C. (2010). HIV transmission risk through anal intercourse: Systematic review, meta-analysis and implications for HIV prevention. International Journal of Epidemiology, 39(4), 1048-1063.
1. Baldwin, J. I., & Baldwin, J. D. (2000). Heterosexual anal intercourse: An understudied, high-risk sexual behavior. Archives of Sexual Behavior, 29(4), 357-373.

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Ovid Technologies, Inc.
- Wiley
Medical
- MedlinePlus Health Information

[1] Aral, S. O., Patel, D. A., Holmes, K. K., & Foxman, B. (2005). Temporal trends in sexual behaviors and sexually transmitted disease history among 18- to 39-year-old Seattle, Washington, residents: Results of random digit-dial surveys. Sexually Transmitted Diseases, 32(11), 710-717.

[2] Aral, S. O., Patel, D. A., Holmes, K. K., & Foxman, B. (2005). Temporal trends in sexual behaviors and sexually transmitted disease history among 18- to 39-year-old Seattle, Washington, residents: Results of random digit-dial surveys. Sexually Transmitted Diseases, 32(11), 710-717.

[3] Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological Framework. International Journal of Social Research Methodology, 8(1), 19-32.

[4] Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological Framework. International Journal of Social Research Methodology, 8(1), 19-32.

[5] Baggaley, R. F., Dimitrov, D., Owen, B. N., Pickles, M., Butler, A. R., Masse, B., & Boily, M. C. (2013). Heterosexual anal intercourse: A neglected risk factor for HIV? American Journal of Reproductive Immunology, 69(SUPPL.1), 95-105.

[6] Baggaley, R. F., Dimitrov, D., Owen, B. N., Pickles, M., Butler, A. R., Masse, B., & Boily, M. C. (2013). Heterosexual anal intercourse: A neglected risk factor for HIV? American Journal of Reproductive Immunology, 69(SUPPL.1), 95-105.

[7] Baggaley, R. F., White, R. G., & Boily, M. C. (2010). HIV transmission risk through anal intercourse: Systematic review, meta-analysis and implications for HIV prevention. International Journal of Epidemiology, 39(4), 1048-1063.

[8] Baggaley, R. F., White, R. G., & Boily, M. C. (2010). HIV transmission risk through anal intercourse: Systematic review, meta-analysis and implications for HIV prevention. International Journal of Epidemiology, 39(4), 1048-1063.

[9] Baldwin, J. I., & Baldwin, J. D. (2000). Heterosexual anal intercourse: An understudied, high-risk sexual behavior. Archives of Sexual Behavior, 29(4), 357-373.

[10] Baldwin, J. I., & Baldwin, J. D. (2000). Heterosexual anal intercourse: An understudied, high-risk sexual behavior. Archives of Sexual Behavior, 29(4), 357-373.

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Promoting safer sex in the context of heterosexual anal intercourse: A scoping review

Affiliations

Promoting safer sex in the context of heterosexual anal intercourse: A scoping review

Authors

Affiliations

Abstract

Similar articles

Cited by

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical