Have they done it by force to you without lubricant? As Dingani explained, in describing how sex differed whether he was sober or drunk: These concerns were echoed by key informants e. You feel them tomorrow. As Kabelo also explained:
These concerns were echoed by key informants e. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Twenty-one participants referred in their interviews to personal experiences with painful RAI, and we focus here on these descriptions. Health service utilization by men who have sex with men in South African cities. If he is rough, you can tell him that he is too rough and you can try a second option. Several strengths and limitations of this study should be noted. Most participants understood the importance of water-based lubricants as an HIV risk reduction tool when used alongside latex condoms, explaining that lubricants decreased friction and reduced the likelihood of condom breakage. Setting sexual boundaries Several participants described setting personal boundaries regarding what they would and would not do sexually as a response to experiences of painful RAI and to avoid anal pain. Four of these participants reported bleeding during or after the encounter, and one reported having hemorrhoids piles at the time of first RAI. Many participants in this study also reported same-sex sexual debut after the age of 16, which is the median age of sexual debut for South African men Pettifor et al. But because of the lube, then the sex it is more easy and bearable I think. And then he was busy like trying to force himself on me. Most participants who were able to recall when they first experienced same-sex attractions reported that they experienced such attractions prior to their first same-sex sexual encounter. Taverns, bars and shebeens: Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: After some time I felt better and I took a bath and came home; when I got there I told myself that the pain would not happen again. Gay-identified men may be the most visible among MSM in South African townships, and consequently the easiest to engage, and yet it will not be sufficient to engage these men alone. HIV vulnerability among male sex workers in Mombasa, Kenya. Perhaps some Black South African MSM are unlikely to switch their sexual roles to manage sexual pain given the importance of sexual role to overall sexual and gender identity. And did you tell him? This participant, who had his first same-sex sexual experience at age 16, described several unexpected consequences, one of which was the disclosure of his sexual behavior to his mother: Sexual and Relationship Therapy. Young people's sexual health in South Africa: This quotation again illustrates that there could be multiple, mutually reinforcing reasons for painful RAI forgetting to use lubricant as a result of alcohol intoxication. Six participants reported that their first same-sex sexual experience, beyond being painful, involved serious anorectal trauma. Okay, what was painful about the sex? A more systematic study of experiences with painful RAI and how those experiences motivate sexual decision making is warranted, and may be relevant to the development of new HIV prevention technologies such as rectal microbicides see for example, Clark et al.
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