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Anal sex is an important yet little studied HIV risk behavior for women. Using information collected on recent sexual encounters, we examined the influence of sex partner and relationship characteristics on the likelihood of engaging in anal sex among women with a high risk of HIV infection. In contrast, emotional closeness and social closeness were not associated with anal sex. Condom use during anal sex was uncommon, and did not vary according to partner or relationship characteristics. Our findings support the need for HIV prevention interventions that target anal sex among heterosexuals, particularly in drug-using populations residing in neighborhoods with elevated levels of HIV prevalence.
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Women who have anal sex: Pleasure or pressure? Implications for HIV prevention

All illustrations by Carly Jean Andrews. You name the drug, and someone says they love having sex on [it]. If you've ever spent any time in a club, on the internet, or at college, you know Johnson's onto something. Most of humanity likes to get freaky. And from the moment we figured out how to burn, ferment, or otherwise synthesize mind-altering substances, from alcohol to cocaine to LSD, we've found ways to incorporate them into our sex lives, expanding and refining the raw pleasures that come with having sex. Given how long—and often—humans have mixed drugs and sex, you'd think we'd understand the two pretty well by now. But as Johnson—who runs clinical trials testing narcotics' effects on human behavior—can attest, drugs affect us all a little differently.
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Relationship characteristics associated with anal sex among female drug users

Anal intercourse is a highly efficient mode of HIV transmission. Nevertheless, there is evidence to suggest that anal intercourse is also widely practiced by women in the US 1 — 4. Given that anal intercourse is associated with higher rates of heterosexual HIV transmission than vaginal intercourse 10 — 13 , women who engage in unprotected anal intercourse with sexual partners of unknown or seropositive status may be at greater risk for acquiring HIV than women who do not practice anal intercourse or who use protection while doing so. Additionally, Halperin 1 found that women who engaged in anal intercourse were less likely to use condoms during anal intercourse than during vaginal intercourse.
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