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Lifespan. "More At-risk Teens And Young Adults Engaging In Anal Intercourse." ScienceDaily. ScienceDaily, 19 November 2008. .
Lifespan. (2008, November 19). More At-risk Teens And Young Adults Engaging In Anal Intercourse. ScienceDaily . Retrieved September 7, 2022 from www.sciencedaily.com/releases/2008/11/081119120147.htm
Lifespan. "More At-risk Teens And Young Adults Engaging In Anal Intercourse." ScienceDaily. www.sciencedaily.com/releases/2008/11/081119120147.htm (accessed September 7, 2022).
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More At-risk Teens And Young Adults Engaging In Anal Intercourse https://www.sciencedaily.com/releases/2008/11/081119120147.htm
A new study by researchers at the Bradley Hasbro Children's Research Center suggests that the incidence of heterosexual anal sex is increasing among teens and young adults.
A new study by researchers at the Bradley Hasbro Children's Research Center suggests that the incidence of heterosexual anal sex is increasing among teens and young adults – particularly those who have recently had unprotected vaginal sex. These findings mirror recent data that show anal sex rates among adults doubled between the years 1995 and 2004.
The study, published online by the American Journal of Public Health, is among the first to report on the little-known factors associated with heterosexual anal intercourse among adolescents and young adults.
"The topic of anal intercourse is often considered taboo – especially when discussed in the context of youth relationships – even though we know that this behavior is a significant risk factor for HIV and other sexually transmitted infections. It's critical that we recognize that more and more young people are engaging in anal sex so we can open the lines of communications and help them protect their sexual health," says lead author Celia Lescano, PhD, of the Bradley Hasbro Children's Research Center (BHCRC).
Researchers assessed the sexual behavior of 1,348 adolescents and young adults between the ages of 15 and 21 who had unprotected sex in the previous three months. They found that 16 percent had engaged in heterosexual anal intercourse within the timeframe, with condoms being used just 29 percent of the time.
Females who had heterosexual anal sex were more likely to be living with their partners, to have two or more sexual partners and to have previously experienced coerced intercourse. Males who engaged in heterosexual anal intercourse were more likely to identify themselves as being homosexual, bisexual or undecided.
"These findings suggest that the factors associated with anal intercourse among females in the study relate to the context and power balance of sexual relationships," says Lescano, who's also an assistant professor of psychiatry (research) at the Warren Alpert Medical School of Brown University. "We must teach teen girls and young women how to be assertive in sexual relationships, such as refusing unwanted sexual acts and negotiating for safer sex, whether it's anal or vaginal."
However, there were several factors related to anal intercourse that were consistent in both genders. In general, those who felt that using condoms decreased the pleasure of sex and those who used drugs at the time of intercourse engaged in riskier behaviors, suggesting that interventions should emphasize that sex can be both pleasurable and safe.
"An open dialogue between health care providers and their young patients about anal intercourse is becoming increasingly important, and clinicians should ask about anal sex during discussions about vaginal intercourse and protection – regardless of the patient's gender or reported sexual orientation," says Lescano.
Study participants in Atlanta, Miami and Providence completed a self-interview designed to measure sexual risk behaviors, relationships, sexual risk attitudes, substance use and mental health. The majority of the group (92 percent) defined themselves as being heterosexual. Overall, 56 percent were female; approximately half of the participants were African American, 24 percent were Hispanic and 20 percent were white.
The study was sponsored by grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Lifespan/Tufts/Brown Center for AIDS Research. In addition to Lescano, the research team included Christopher D. Houck and Larry K. Brown of the BHCRC and Alpert Medical School; David Pugatch of Rhode Island Hospital and Alpert Medical School; Ralph J. DiClemente of Emory University; M. Isabel Fernandez of the University of Miami; William E. Schlenger of the Research Triangle Institute; Barbara J. Silver of SAMHSA; and Glenn Doherty, formerly of the BHCRC.
This research was conducted with the support of the Project SHIELD Study Group – a federally-funded prevention/intervention program aimed at developing and testing ways to encourage and enable behavior change among two subgroups at high risk for HIV infection: adolescents/young adults and women.
Materials provided by Lifespan . Note: Content may be edited for style and length.
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Rectal bleeding occurs in about 20 percent of the population annually and is commonly caused by benign problems; however, it can be indicative of colorectal cancer. Early detection of such neoplasms reduces cancer-related mortality. The risk of colorectal cancer before 40 years of age is low, and most recommendations for colon-cancer screening involve persons older than 40. Evaluation of rectal bleeding in older adults should include examination of the entire colon. In younger patients with rectal bleeding, the risk-benefit aspects of a full colon evaluation are less clear. Lewis and associates assessed the cost-effectiveness of a variety of evaluation strategies in young patients with asymptomatic rectal bleeding.
The authors developed a Markov analytic decision model of a 35-year-old patient presenting with asymptomatic rectal bleeding, defined as blood in the toilet bowl, on the tissue paper, or mixed with stool. This model analyzed nine potential evaluation strategies. The effectiveness of each diagnostic strategy was determined using probability estimates of rates of colonic neoplasms in persons 30 to 39 years of age; of the likelihood of persons with rectal bleeding having a colonic neoplasm; of rectal bleeding caused by benign anal disease; and of the rate at which adenomas progressed to invasive cancer. Direct medical costs for testing and care were obtained from Medicare reimbursement scales and National Institute of Cancer data.
The “no evaluation” strategy offered the lowest life expectancy, while colonoscopy or barium enema plus flexible sigmoidoscopy in all patients produced the greatest life expectancy. Strategies incorporating anoscopy offered greater life expectancy than no evaluation, but lower life expectancy than strategies that visualized all or part of the colon. Diagnostic strategies visualizing the entire colon offered greater life expectancy than strategies visualizing only part of the colon.
The incremental cost of flexible sigmoidoscopy was less than $5,300 per year of life gained; for flexible sigmoidoscopy plus barium enema, it was $23,918 per year of life gained; for colonoscopy, it was $50,193 per year of life gained. As anticipated, this cost increased for persons 25 years of age and decreased for persons 45 years of age because of variations in colon cancer incidence.
The authors conclude that, based on a cost-effectiveness analysis, rectal bleeding in adults older than the mid-30s should be evaluated with colonoscopy regardless of findings on anoscopy. In patients in their mid-20s or younger, flexible sigmoidoscopy alone or anoscopy followed by flexible sigmoidoscopy in patients without anal disease is probably more cost-effective than evaluation of the entire colon.
Lewis JD, et al. Initial evaluation of rectal bleeding in young persons: a cost-effectiveness analysis. Ann Intern Med. January 15, 2002;136:99-110.
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