When Men Don't and Women Do

Just 23% of New York City women who had anal sex with men in the past year reported always using condoms, a city Department of Health and Mental Hygiene report has found. Among men who have sex with men, 61% reported always using a condom during anal sex. The study was based on data from an annual telephone survey of about 10,000 adult residents conducted in 2007.

Anal tissue is very fragile, and the risk of getting HIV through unprotected receptive anal sex is similar for men and women, according to additional information from the report. During a single act of unprotected anal sex, a woman's risk of acquiring HIV from an infected male partner is about 30 times the risk of infection during a single act of unprotected vaginal sex, several studies suggest.

In New York City about 5.6% of women ages 18-64 reported anal sex with men in the previous year. The proportion doing so rose from 4% of those reporting one partner in the last year, to 9% of those reporting two partners and 15% of those reporting three or more partners. Anal sex reports declined by age, from 11% among those ages 18-24, to 7% among ages 25-44, and 2% for ages 45-64.

In 2008 more than nine in 10 women with known risk factors who were newly diagnosed with HIV acquired the infection sexually, a 7% increase over 2006. It is not known how many infections among women were from unprotected anal sex, but "since unprotected anal sex is far more likely to transmit HIV than unprotected vaginal sex, it is probably the source of many infections," the report said.

In addition, women reporting unprotected anal sex were about as likely to report a recent HIV test (35%) as those who did not have anal sex at all (39%). While most women who had unprotected anal sex saw a health care provider in the past year, only 32% were tested for HIV.

"For both women and men, the overall message is clear: Never engage in unprotected anal sex. Use a condom every time," said Thomas Farley, the city's health commissioner.

Access the full report: "Women, Unprotected Anal Sex and HIV Risk.”