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BMJ Open 4:e004996 doi:10.1136/bmjopen-2014-004996
  • Sexual health
    • Research

Anal heterosex among young people and implications for health promotion: a qualitative study in the UK

Press Release
  1. R Lewis
  1. Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Dr Cicely Marston; Cicely.Marston{at}lshtm.ac.uk
  • Received 4 February 2014
  • Revised 25 April 2014
  • Accepted 23 May 2014
  • Published 18 July 2014

Abstract

Objective To explore expectations, experiences and circumstances of anal sex among young people.

Design Qualitative, longitudinal study using individual and group interviews.

Participants 130 men and women aged 16–18 from diverse social backgrounds.

Setting 3 contrasting sites in England (London, a northern industrial city, rural southwest).

Results Anal heterosex often appeared to be painful, risky and coercive, particularly for women. Interviewees frequently cited pornography as the ‘explanation’ for anal sex, yet their accounts revealed a complex context with availability of pornography being only one element. Other key elements included competition between men; the claim that ‘people must like it if they do it’ (made alongside the seemingly contradictory expectation that it will be painful for women); and, crucially, normalisation of coercion and ‘accidental’ penetration. It seemed that men were expected to persuade or coerce reluctant partners.

Conclusions Young people's narratives normalised coercive, painful and unsafe anal heterosex. This study suggests an urgent need for harm reduction efforts targeting anal sex to help encourage discussion about mutuality and consent, reduce risky and painful techniques and challenge views that normalise coercion.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/

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