Heterosexual anal intercourse: Prevalence, cultural factors, and HIV infection and other health risks, Part I
Heterosexual anal intercourse: Prevalence, cultural factors, and HIV infection and other health risks, Part I
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DOI：
10.1089/apc.1999.13.717
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发表时间：
1999-12-01
影响因子：
4.9
通讯作者：
Halperin, DT
中科院分区：
文献类型：
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作者：
Halperin, DT
对异性恋艾滋病毒传播的研究一直发现肛交是血清转换的高度预测风险因素。然而，大多数针对异性恋者的艾滋病预防信息，可能是受到文化禁忌的影响，不承认这种性行为，继续强调阴道和越来越多的口交传播。在北美和拉丁美洲以及南亚、非洲和其他地区的部分地区，很大一部分性活跃的妇女和男子似乎严重低估了肛交的健康风险。在异性恋者中，肛交时避孕套的使用率几乎普遍低于阴道性交。本综述探讨了一般人群中的肛交，包括其在世界各地区的流行情况，相关的社会文化因素，以及其他相关的健康问题，包括肛门直肠性病，B型肝炎感染，HPV相关的肛门癌的妇女。美国的调查和其他数据表明，就绝对数字而言，女性比同性恋男性多七倍，从事无保护的接受性肛交。对包括双性恋男子、注射毒品使用者、女性性工作者、市中心青少年和血清不一致的异性恋夫妇在内的高风险亚群体的研究表明，特别有可能感染或传播艾滋病毒的人也更有可能进行肛交。考虑到这一发现，沿着艾滋病毒感染的效率更高以及避孕套使用率更低，在某些人群中，异性性传播的很大一部分是由于肛交。在艾滋病/性病预防、妇女保健和其他健康促进方案中，必须更加重视这种典型的耻辱和隐蔽的性行为。
Studies of heterosexual HIV transmission have consistently found anal intercourse to be a highly predictive risk factor for seroconversion. Yet most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex transmission. The health risks of anal sex appear to be severely underestimated by a substantial proportion of sexually active women and men in North and Latin America as well as parts of South Asia, Africa, and other regions. Among heterosexuals reported rates of condom use are nearly universally lower for anal than for vaginal intercourse. This review examines anal sex among the general population, including its prevalence in various world regions, related sociocultural factors, and other associated health problems including anorectal STDs, Hepatitis B infection, and HPV-related anal cancer in women. U.S. survey and other data suggest that, in terms of absolute numbers, approximately seven times more women than homosexual men engage in unprotected receptive anal intercourse. Research among higher risk subpopulations, including bisexual men, injecting drug users, female sex workers, inner-city adolescents, and serodiscordant heterosexual couples, indicates that persons particularly at risk of being infected by or transmitting HIV are also more likely to practice anal sex. Considering this finding, along with the much greater efficiency for HIV infection as well as lower rates of condom usage, a significant proportion of heterosexual transmission in some populations is due to anal intercourse. This typically stigmatized and hidden sexual practice must be given greater emphasis in AIDS/STD prevention, women's care, and other health promotion programs.