Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. Twenty-one participants referred in their interviews to personal experiences with painful RAI, and we focus here on these descriptions. Open in a separate window Note. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. And their accounts suggest that they had sometimes ended up having anal sex without giving their explicit consent. As Kabelo also explained: The interviews explored the range and meaning of different sexual practices, and included nine group and 71 individual in-depth discussions in , and further interviews of 43 of the in-depth interviewees in
Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. An exploration into anal sexuality. Afterwards I told my friend, and my friend explained to me what was happening. Sexual difficulties, concerns, and satisfaction in homosexual men: Attitudes, such as the inevitability of pain for women, or the failure to recognise or reflect on potentially coercive behaviour, seem to go unchallenged, which risks coercion emerging as a dominant element of anal sex, they add. They interviewed year olds from diverse social and economic backgrounds living in different parts of the country: MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. So my mother asked me what I did and I told her. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. Sexual and Relationship Therapy. Some participants set sexual boundaries specifically related to lubricant use, saying that they would not engage in anal intercourse if lubricant was not available. It gets difficult because you have to tell him what to do, where to penetrate, what not to do, things like that. The pain alerted me to go to the toilet, I felt like defecating. The group discussions focused on what sexual practices participants had heard of, what they felt about them, and whether they thought their peers would engage in them—and if so, under what circumstances. Six participants reported that their first same-sex sexual experience, beyond being painful, involved serious anorectal trauma. Open in a separate window Note. Most participants understood the importance of water-based lubricants as an HIV risk reduction tool when used alongside latex condoms, explaining that lubricants decreased friction and reduced the likelihood of condom breakage. Alcohol and sexual risk behavior among men who have sex with men in South African township communities. Although it was the lack of lubricant in the context of sexual encounters that participants discussed in relation to painful RAI, participants also commented more generally on the limited availability of lubricants in their townships. The epidemiology of rape and sexual coercion in South Africa: Visited times, 1 visits today. These include a lack of concern about getting consent, or the levels of pain female partners might experience, and competitiveness among young men to have anal sex with women. Yes, we talk about it first. Taverns, bars and shebeens:
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