(WOMENSENEWS)–Rev. Jeremiah Wright, Sen. Barack Obama’s by now estranged retired pastor, is not alone in believing that the U.S. government “invented the HIV virus as a means of genocide against people of color.”
Distrust of our public health system has lingered in the African American community ever since the conduct of the infamous Tuskegee Syphilis Study, which ended when it became widely known in 1972. News media ended the silence by reporting that white researchers for the U.S. Public Health Service withheld medication or any other treatment from nearly 400 black men suffering from syphilis. The rationale was that the researchers wished to determine the exact effects of the disease on the human body.
Notwithstanding this shameful history, Wright’s incendiary comment was unwarranted and destructive. I wish he’d dare to raise an actual HIV-AIDS threat that is being dangerously silenced by taboo.
It’s a threat that the public health community continues to ignore and that we must talk about: women’s unprotected anal intercourse with male partners.
According to the Centers for Disease Control and Prevention, women now represent almost one-quarter of Americans with HIV-AIDS. A whopping 79 percent of the females infected with HIV are women of color. Most contracted the disease from “heterosexual contact,” in other words, from their husbands or boyfriends.
Sexual Practices Overlooked
The Centers for Disease Control and Prevention collects the most widely distributed data on HIV-AIDS but does not publish a breakdown about the specific sexual practices that might be implicated and appears not to collect such data. My own research, however, suggests that anal intercourse may play a significant role in heterosexual transmission.
Research on heterosexual anal intercourse has been scarce, but there has been some, and it demonstrates that heterosexual anal intercourse is not new, nor is it limited to any one group of women. The well-known Kinsey Institute, discussing data collected between 1938 and 1963, reported that 9 percent of women had had anal sex in the previous year, and that 24 percent of female college students had done so at least once in their lives. A 2005 report from the National Center for Health Statistics found that 35 percent of women had had anal intercourse with a man. It is not clear, however, whether more women are actually having anal sex, or whether women today are just more honest about it.
From 2002 to 2007, I conducted several studies aimed at improving condom use among African American and Latina adolescent and young adult women. As part of these studies, we collected data from 400 teens and young women about their sexual behaviours, all their sexual behaviours.
What we found was alarming.
Between one-fourth and one-third of the young women in our studies reported that they had had anal intercourse. On average, they started when they were 16 and a half years old.
Less Likely to Use Condoms
The majority did not use a condom during anal sex. In fact, they were much more likely to use a condom during vaginal sex than during anal intercourse. They didn’t know that having anal intercourse without a condom is risky, but they had heard lots of messages about the importance of using condoms when they have “regular” sex.
These young women seemed to believe that anal intercourse without a condom is safe, perhaps because nobody had told them it isn’t. We can’t waste any time in correcting that impression.
In the 1980s, HIV spread rapidly among gay men because they engaged in unprotected anal sex. Receptive anal intercourse is especially dangerous, for complex reasons having to do with the biological makeup of the intestines. Researchers estimate that it is 5 to 20 times riskier than receptive vaginal intercourse. Since women are consistently receptive partners, they incur much greater risk than their male partners.
Women have a right to know these facts. It is critically important for them to understand how risky unprotected anal intercourse is.
Hard to Get the Word Out
However, I have found it extremely difficult to get the word out.
Even though I have published numerous articles in professional journals, my attempts to publish these findings in major health journals have been futile. Similarly, my search for funding to conduct further studies on women and anal intercourse has also been unsuccessful.
Does the dearth of openness and information on this subject stem from embarrassment? I have found that even seasoned professionals can be reluctant to talk to me about it.
Whatever the reason, the health community’s collective spurning of the topic of heterosexual anal sex means that there is no reliable research on which to base effective interventions. Meanwhile, women may be dying because of that embarrassment.
Some researchers think that teens have anal sex to avoid losing their virginity or to prevent pregnancy. However, this wasn’t the case in the studies I conducted. All the young women in our research group had lost their virginity, and, in order to qualify for the studies, they had to be using birth control pills or another method of birth control besides condoms.
Although we need more research in this area, it’s unlikely that will happen as long as science is constricted by political or ideological considerations. Teaching about anal intercourse is clearly not aligned with the government’s emphasis on abstinence-only education.
Not only is there a large research gap, there is also no public discussion about the risk for women of engaging in unprotected anal intercourse. Hiding our heads in the sand won’t help.
Telling people that AIDS is the white man’s way of exterminating African Americans is counterproductive.
Clearly, we need to reach out to women with an educational campaign that raises awareness about the danger of using “the back door” without condoms. Our public health community has conveyed this message fairly successfully to gay men. Now it’s time to break the silence in the heterosexual community and give women the information they need to protect themselves. This is a public health issue not a political issue. Women’s lives are at stake.
Carol F. Roye, EdD, RN, CPNP, is a professor at Hunter College Schools of the Health Professions and director of the school’s Center for Nursing Research. She is also a pediatric nurse practioner, with a practice in adolescent primary and reproductive health care.
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For more information:
Women’s Health Is a Value: CarolRoye.org
Henry J. Kaiser Family Foundation, Women’s Health Policy:
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