The Open AIDS Journal

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Anal Intercourse and HIV Risk Among Low-Income Heterosexual Women: Findings from Chicago HIV Behavioral Surveillance

Britt S Livak*, Nikhil G Prachand, Nanette Benbow
Chicago Department of Public Health, STI/HIV Division, 333 South State Street, Suite200, Chicago, IL60604, USA



Anal intercourse (AI) is a highly efficient route for HIV transmission and has not been well elucidated among heterosexual (HET) women. Heterosexual women living in impoverished urban areas in the US are at increased risk for HIV acquisition. We aim to describe rates of AI and characteristics associated with AI among heterosexual women at increased risk for HIV acquisition living in Chicago.


The Chicago Department of Public Health conducted a survey of HET during 2007 as part of the National HIV Behavioral Surveillance System. Venue-based, time-location sampling was used to select participants from venues in high-risk areas (census tracts with concurrently high rates of heterosexual AIDS and household poverty). Eligible participants were interviewed anonymously and offered a HIV test.


In total, 407 heterosexual women were interviewed. Seventy-one (17%) women reported having AI in the past 12 months, with 61 of the 71 (86%) reporting unprotected AI. In multivariate analysis, women who engaged in AI were more than three times as likely to have three or more sex partners in the past 12 months (OR=3.27, 95% CI 1.53-6.99). AI was also independently associated with STI diagnosis in the past 12 months (2.13, 95% CI 1.06-4.26), and having sexual intercourse for the first time before the age of 15 years (2.23, 95% CI 1.28-3.89).


AI was associated with multiple high risk behaviors including a greater number of sexual partners, STI diagnosis, and earlier age at first sex. The combination of risk factors found to be associated with AI call for new HIV prevention services tailored to the needs of women and young girls living in poverty.

Keywords: HIV/AIDS, heterosexual, anal intercourse, women, behavioral surveillance..

Article Information

Identifiers and Pagination:

Year: 2012
Volume: 6
Issue: Suppl 1
First Page: 142
Last Page: 148
Publisher Id: TOAIDJ-6-142
DOI: 10.2174/1874613601206010142

Article History:

Received Date: 14/4/2011
Revision Received Date: 24/6/2011
Acceptance Date: 25/7/2012
Electronic publication date: 7/9/2012
Collection year: 2012

© Livak et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Chicago Department of Public Health, STI/HIV Division, 333 South State Street, Suite200, Chicago, IL60604, USA; Tel: 312-747-9546; Fax: 312-745-3923; E-mail:

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