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Elizabeth Boskey, Ph.D.

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By April 30, 2010

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A recent survey from the New York Department of Health suggests that straight women aren't doing so well at practicing safe sex when they're having anal sex. The problem is particularly acute among young women - aged 18-24 - who are not only substantially more likely to have anal sex but much less likely to consistently use condoms while doing it.

Why are young women so unreliable about practicing safe anal sex? People have proposed various theories from issues with virginity-focused abstinence education to media campaigns that only talk about the dangers of anal sex for gay men. They're all quite reasonable, but the real question is... what do we do about it? There's no question that we need to do something. Unprotected anal sex puts women (and their partners) at a much greater risk of HIV transmission than unprotected vaginal sex, and the women who are having it also aren't doing a great job of getting regularly screened.

The health department recommendations are good ones. They state that doctors should:

  1. explicitly ask their patients about vaginal, anal, and oral sex and whether they're consistently using condoms for these activities.
  2. counsel the patients who have anal sex about doing so safely.
  3. screen any patients who have unprotected anal sex for not only HIV but anal chlamydia and gonorrhea.
but I think that this issue reflects a more fundamental societal problem. It seems inconceivable to me that anyone in this day and age could be unaware of the potential risks of anal sex. When I was in school, the dangers of anal sex were one of the biggest components of the sex education curriculum, and although that might have been excessive it was better than not having them discussed at all. Today, on the other hand, it seems like people are happy to have anal sex, but they're not willing to talk about it. Unfortunately, until we can discuss anal sex, as a society, without giggling or making stupid jokes, it's going to be impossible to provide effective education about risk.
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