Heterosexual anal sex is perceived to be a common practice in southern Tanzania

How long-distance truck drivers and villagers in rural southeastern Tanzania think about heterosexual anal sex: a qualitative study.

Mtenga S, Shamba D, Wamoyi J, Kakoko D, Haafkens J, Mongi A, Kapiga S, Geubbels E. Sex Transm Infect. 2015 Jun 25. pii: sextrans-2015-052055. doi: 10.1136/sextrans-2015-052055. [Epub ahead of print]

Objective: To explore ideas of truck drivers and villagers from rural Tanzania about heterosexual anal sex (HAS) and the associated health risks.

Methods: Qualitative study using 8 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) with truck drivers and 16 IDIs and 4 FGDs with villagers from the Morogoro region. Study participants included 24 women and 46 men. Data analysis was performed thematically employing standard qualitative techniques.

Results: Reasons why men would practice HAS included sexual pleasure, the belief that anal sex is safer than vaginal sex, alternative sexual practice, exploration and proof of masculinity. Reasons why women would practice HAS included financial need, retaining a partner, alternative for sex during menses, pregnancy prevention and beauty enhancement because HAS is believed to 'fatten the female buttocks'. Most participants believed that condoms are not needed during HAS. This was linked to the ideas that infections only 'reside in wet places' (vagina) and that the anus is not 'conducive' for condom use; condoms reduce 'dryness' and 'friction' (pleasure) and may 'get stuck inside'.

Conclusions: The study participants reported practices and ideas about HAS that put them at risk for HIV and sexually transmitted infections. Greater attention to education about HAS is urgently needed in Tanzania, where this sexual practice is still regarded as a taboo. This study offers useful information that could be included in sex education programmes.

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Editor’s notes: This paper explores the views of truck drivers and villagers on heterosexual anal sex. During in-depth interviews and focus group discussions in the Morogoro region of the United Republic of Tanzania the researchers asked participants about their opinions on sexual practices more broadly and specifically on heterosexual anal sex. The findings reveal that the participants perceive that heterosexual anal sex is becoming a common practice. In discussing why men practice heterosexual anal sex, the participants suggested that sexual pleasure, fulfilment of ideas of masculinity, and sexual exploration were the main reasons. For women, however, the participants suggested that the main reasons were financial, maintaining their relationships, pregnancy prevention, for sex during menstruation, and ‘fattening female buttocks’. When asked about HIV protection, many participants did not perceive that condom protection was feasible or required during heterosexual anal sex. The findings, while based on perceptions of the behaviour of ‘others’ and not on own accounts, suggest that heterosexual anal sex is more widespread in Tanzania than often assumed. And if it is a widespread and unprotected sexual practice, it is an important route of HIV infection.

United Republic of Tanzania
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