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Big tits latina tumblr. Dominica Phoenix works her hairy snatch.. Bbw party salt in Foggia. Amber lynn lingerie. Sexy naked tsunade and naruto. Kristina rose porn gifs. Taylor rain anal torrents. How To Please A Nigerian Man Sexually. Nh sex offender database. In-depth interviews were conducted with 81 Black MSM ages 20—39 years who were purposively recruited from four townships. The semi-structured interviews addressed sexual behavior and identity, alcohol use, and safer sex. Pain during RAI was brought up by many participants without specific prompting from the interviewer. Analysis of Free hugh cocks painful anal interview transcripts revealed that pain was a common feature of first RAI experiences but was not limited to first-time experiences. The participants attributed pain during RAI to partner characteristics, interpersonal dynamics, lack of lubricant, and alcohol use continue reading non-use. The main strategies participants used to address pain during RAI were setting sexual boundaries and lubricant use; a small number of participants reported purposefully consuming alcohol to prevent the pain associated with RAI. Pain can occur during anal penetration when the external anal sphincter is not relaxed; because the anus does not self-lubricate, lubricating substances are also needed to reduce pain from friction Hollows, Other causes of pain during anal penetration may be sexually transmitted infections STIs such as herpes, or other anal health issues such as fissures and hemorrhoids Hollows, Experiences of pain during RAI are not uncommon and vary on different dimensions e. Pain during RAI may be either situational i. In a sample of primarily white, gay-identified men in the U. Such symptoms could result from or precede incidents of painful RAI. In the African context, factors that are unique vulnerabilities for MSM elevate the issue of painful RAI from one of individual to public Free hugh cocks painful anal significance. Free hugh cocks painful anal the backdrop of the criminalization of homosexuality and high HIV Free hugh cocks painful anal in many African countries, African MSM face substantial barriers in accessing culturally appropriate and competent sexual link care. In some cases this leads men to self-medicate, seek treatment from unqualified health workers, or not be forthright about their symptoms when seeking treatment Okal et al. African MSM also have restricted access to condom-compatible lubricants Baral et al. Riya sen sexy photos Heroines hot boobs images.

Free iphone sexy girls in bikini being fuck porn. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained. I would say to gays, the lubricants Free hugh cocks painful anal the best things since sliced bread. Go here initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this.

But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva.

For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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.

Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent Free hugh cocks painful anal failure: Because I have experienced that the condom—it breaks when you are not using lubrication.

Participants attributed painful RAI to various Free hugh cocks painful anal link coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions.

Their responses to Free hugh cocks painful anal RAI can also be optimized so that they yield the greatest health benefits i.

Wwwxxxporen 2018com Watch Video porno carry. Participants commonly described these experiences as painful. A smaller group of men described them as both painful and pleasurable. Six participants reported that their first same-sex sexual experience, beyond being painful, involved serious anorectal trauma. Four of these participants reported bleeding during or after the encounter, and one reported having hemorrhoids piles at the time of first RAI. The story shared by Tlotliso exemplified the potential vulnerability of MSM in their first sexual encounters, which could be amplified by the need or desire for secrecy about engaging in same-sex sexual behavior. 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:. So around 11 a. It was pain from behind. It was painful but I ignored it. The pain alerted me to go to the toilet, I felt like defecating. I went to the toilet and defecated, and as I was busy, blood dripped in the toilet. Afterwards I told my friend, and my friend explained to me what was happening. 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. On Monday, when I went to the toilet again, the same thing happened and my mom was at home. When I got there, the doctor told me to climb on the bed and he inspected me and when he was done he told my mother that I am being naughty and that I know what I did and that I will tell her what I did. So my mother asked me what I did and I told her. This quotation illustrates a range of negative outcomes that could possibly have been prevented had Tlotliso received some advance education about how to avoid or address such outcomes. Participants were asked about subsequent same-sex sexual experiences i. Twenty-one participants referred in their interviews to personal experiences with painful RAI, and we focus here on these descriptions. Additional participants made reference to anal sex as painful, though they were not necessarily describing personal experiences i. The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. It gets difficult because you have to tell him what to do, where to penetrate, what not to do, things like that. Participants described other attributions for painful RAI that seemed to arise during the sex act: Several participants reported experiencing pain as a result of anal intercourse that, although consensual, was either too rough, too fast, or too slow. Sizwe shared the following story about a negative sexual experience:. But he was my boyfriend, my steady boyfriend, so like I had to just, you know, end the relationship because of that sex. He was so controlling to me and he wanted whatever he wanted. Lutendo and Tumelo shared similar accounts. The experience, that person he controlled me over and he was just doing it and he was rushed, he was rough and rushed. Interviewers generally did not probe for specifics about the type of lubricants referred to in these instances, however. Although it was the lack of lubricant in the context of sexual encounters that participants discussed in relation to painful RAI, participants also commented more generally on the limited availability of lubricants in their townships. Unlike condoms, which were widely available for free, lubricants generally needed to be purchased at venues located outside the townships such as pharmacies and adult shops. Participants linked alcohol consumption to painful RAI in several ways. RAI was painful to some participants when they were sober, and was less painful when they were drunk. As Dingani explained, in describing how sex differed whether he was sober or drunk:. When a guy is too rough, you can feel the pain and ask him to stop. As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later:. You feel them tomorrow. Finally, a few participants noted that RAI could be painful when their partners were drunk, either because they would have difficulty reaching a climax or became more aggressive. These strategies are discussed in further detail below. A small number of participants used strategies that would not fall into either of these categories. For example, although a larger number of participants had generally discussed alcohol use as a context for painful RAI, two participants reported using alcohol purposefully to prevent the pain associated with RAI. 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. These actions included abstaining from anal intercourse; having non-penetrative sex; and having rules about sex acts or sexual positions one would or would not perform. Dingani explained how he would communicate his boundaries to his sexual partners:. When you are having sex do you negotiate what type of sex you want and do you also give the other person a chance to voice what he wants? Yes, we talk about it first. So I will tell him to think of something. Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis:. When you are with a man would it be clear from the start what type of sex you will have and how is it clear what type of sex you will be having? It depends on the guy, whether he is rough or gentle. If he is rough, you can tell him that he is too rough and you can try a second option. The above example illustrates that boundary-setting might happen not only case-by-case, but from moment to moment, as needed to ensure a pleasurable sexual experience. This example also illuminates the overlapping factors that could structure the experience: Some participants set sexual boundaries specifically related to lubricant use, saying that they would not engage in anal intercourse if lubricant was not available. As Kabelo also explained:. Sexual boundaries were not always respected, however, particularly from sexually abusive partners. For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful:. Some other guy, we agreed to each other, we went to his place and then he was beating me because, how can I put it? He could not like penetrate it to me. And then he was busy like trying to force himself on me. Because I was telling him he could not enter me…He started to beat me and hit me with a bottle…I was scared of him…He tried to force himself on me. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about pain during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants raised this issue themselves. Despite these limitations, the fact that participants in this study discussed painful RAI in relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared for their first same-sex sexual experiences. In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Kalichman, ; painful RAI can occur in the context of heterosexual sexual encounters, as well. Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI. 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. The participants in this study reported that while condoms are widely available for purchase or for free , lubricants are more difficult to obtain, as they are offered in fewer places and are only rarely made available for free. The cost of commercial lubricants to the participants in our study, many of whom were unemployed, was considered expensive. There are also a limited number of places to which MSM can be referred for sexual health care e. Efforts to capacitate local service providers and community-based organizations to address the sexual health needs of MSM will therefore be essential. Capacitating health care workers should include skills-building around non-stigmatizing clinical care of MSM and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity. 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. Putting the spotlight on this issue may yield added and renewed health and wellness benefits to individual men, but is also potentially an important part of HIV and STI prevention efforts focused on this population. Theo Sandfort, Ph. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Robert H. Remien, Ph. We wish to thank OUT Well-being, the communities that partnered with us in conducting this research, and the study 28 participants for their contributions. We also thank study staff at all participating institutions for their work and dedication. Arch Sex Behav. Author manuscript; available in PMC Feb 1. Kate L. Collier , 1 Theo G. Sandfort , 1 Vasu Reddy , 2, 3 and Tim Lane 4. Theo G. Find articles by Vasu Reddy. Find articles by Tim Lane. Copyright notice. The publisher's final edited version of this article is available at Arch Sex Behav. See other articles in PMC that cite the published article. The Present Study Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. Analysis Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, Table 1 Characteristics of Study Participants Pseudonym. Open in a separate window. First same-sex sexual experiences Participants reported on their first same-sex sexual experiences and how old they were at the time. 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: As Tlotliso goes on to explain, he eventually needed to seek medical intervention: Attributions for Painful Receptive Anal Intercourse Participants were asked about subsequent same-sex sexual experiences i. Partner characteristics The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. Interpersonal dynamics Participants described other attributions for painful RAI that seemed to arise during the sex act: Sizwe shared the following story about a negative sexual experience: Okay, what was painful about the sex? Was it something that you felt needed to be reported? And did you tell him? Alcohol consumption Participants linked alcohol consumption to painful RAI in several ways. Trinity gets fucked with a huge cock. Restrained bondage sub fucked by black master. Giant black cock anal makes bitch scream - MP4 P. Making him the first anal to the beautiful culona my neighbor screaming as tasty round ass well dril. Rough Anal Pain: Crying Wife forced in to anal. Mandingo rips open white whores asshole. Monica Sexxxton crams a black huge monster in her ass!.

This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating Free hugh cocks painful anal likes and dislikes Free hugh cocks painful anal the study interviewers and could potentially be empowered to do the same during sexual encounters.

Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U.

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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e.

Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic.

There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about Free hugh cocks painful anal during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants Free hugh cocks painful anal this issue themselves.

Despite these limitations, the fact that participants in this study discussed painful RAI continue reading relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared Free hugh cocks painful anal their first same-sex sexual experiences.

In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of Free hugh cocks painful anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Free hugh cocks painful anal, ; painful RAI can occur in the context of heterosexual sexual encounters, as well.

Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI.

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 Wierd amateur girl pissing these men alone.

The participants in this study reported that while condoms are widely available for purchase or for freelubricants are more difficult to obtain, as they are offered in fewer places and are only rarely made available for free.

The cost of commercial lubricants to the participants in our study, many of whom were unemployed, was considered expensive. There are also a Free hugh cocks painful anal number of places to which MSM can be referred for sexual health care e.

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Efforts to capacitate local service providers and community-based organizations to address the sexual health needs of MSM will therefore be essential.

Capacitating health care workers should include skills-building around non-stigmatizing clinical care of Free hugh cocks painful anal and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity.

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. Putting the spotlight on this issue may yield added and renewed health and wellness benefits to individual men, but is also potentially an important part of HIV and STI prevention efforts focused on this Free hugh cocks painful anal.

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Theo Sandfort, Ph. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Robert H. Remien, Ph. We wish to thank OUT Well-being, the communities that partnered with us in Free hugh cocks painful anal this research, and the study 28 participants for their contributions. We also thank study staff Free hugh cocks painful anal all participating institutions for their work and dedication.

Arch Sex Behav. Author manuscript; available in PMC Feb 1. Kate Visit web page. Collier1 Theo G. Free hugh cocks painful anal1 Vasu Reddy2, 3 and Tim Lane 4. Theo G. Find articles by Vasu Free hugh cocks painful anal. Find articles by Tim Lane. Copyright notice. The publisher's final edited version of this article is available at Arch Sex Behav.

See other articles in PMC that cite the published article. The Present Study Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities.

Analysis Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, Table 1 Characteristics of Study Participants Pseudonym. Open in a separate window. First same-sex sexual experiences Participants reported on their first same-sex sexual experiences and how old they were at the time. 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: As Tlotliso goes on to explain, he eventually needed to seek medical intervention: Attributions for Painful Receptive Anal Intercourse Participants were Free hugh cocks painful anal about subsequent same-sex sexual experiences i.

Partner characteristics The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. Interpersonal dynamics Participants described other attributions for painful RAI that seemed source arise during the sex act: Sizwe shared the following story about a negative sexual experience: Okay, what was painful about the sex?

Was it something that you felt needed to be reported? And did you tell him? Alcohol consumption Participants linked alcohol consumption to painful RAI in several ways. As Dingani explained, in describing how sex differed whether he was sober or drunk: As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later: 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.

Dingani explained how he would communicate his boundaries to his sexual Free hugh cocks painful anal You speak about frozen; which other positions do you negotiate? Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis: How big it is…?

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And most of the time they agree? Yes, they agree. As Kabelo also explained: Have they done it by force to you without lubricant?

Finddaggering Porn Watch Video nerdnudes com. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about pain during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants raised this issue themselves. Despite these limitations, the fact that participants in this study discussed painful RAI in relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared for their first same-sex sexual experiences. In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Kalichman, ; painful RAI can occur in the context of heterosexual sexual encounters, as well. Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI. 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. The participants in this study reported that while condoms are widely available for purchase or for free , lubricants are more difficult to obtain, as they are offered in fewer places and are only rarely made available for free. The cost of commercial lubricants to the participants in our study, many of whom were unemployed, was considered expensive. There are also a limited number of places to which MSM can be referred for sexual health care e. Efforts to capacitate local service providers and community-based organizations to address the sexual health needs of MSM will therefore be essential. Capacitating health care workers should include skills-building around non-stigmatizing clinical care of MSM and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity. 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. Putting the spotlight on this issue may yield added and renewed health and wellness benefits to individual men, but is also potentially an important part of HIV and STI prevention efforts focused on this population. Theo Sandfort, Ph. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Robert H. Remien, Ph. We wish to thank OUT Well-being, the communities that partnered with us in conducting this research, and the study 28 participants for their contributions. We also thank study staff at all participating institutions for their work and dedication. Arch Sex Behav. Author manuscript; available in PMC Feb 1. Kate L. Collier , 1 Theo G. Sandfort , 1 Vasu Reddy , 2, 3 and Tim Lane 4. Theo G. Find articles by Vasu Reddy. Find articles by Tim Lane. Copyright notice. The publisher's final edited version of this article is available at Arch Sex Behav. See other articles in PMC that cite the published article. The Present Study Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. Analysis Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, Table 1 Characteristics of Study Participants Pseudonym. Open in a separate window. First same-sex sexual experiences Participants reported on their first same-sex sexual experiences and how old they were at the time. 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: As Tlotliso goes on to explain, he eventually needed to seek medical intervention: Attributions for Painful Receptive Anal Intercourse Participants were asked about subsequent same-sex sexual experiences i. Partner characteristics The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. Interpersonal dynamics Participants described other attributions for painful RAI that seemed to arise during the sex act: Sizwe shared the following story about a negative sexual experience: Okay, what was painful about the sex? Was it something that you felt needed to be reported? And did you tell him? Alcohol consumption Participants linked alcohol consumption to painful RAI in several ways. As Dingani explained, in describing how sex differed whether he was sober or drunk: As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later: 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. Dingani explained how he would communicate his boundaries to his sexual partners: You speak about frozen; which other positions do you negotiate? Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis: How big it is…? And most of the time they agree? Yes, they agree. As Kabelo also explained: Have they done it by force to you without lubricant? For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful: And so why did he end up beating you up? Lubricant use The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained, I would say to gays, the lubricants are the best things since sliced bread. A national school-based survey in South Africa. International Journal for Equity in Health. BMC Public Health. PLoS One. Frequency, patterns, and preferences of lubricant use during anal intercourse within male sexual partnerships in Lima, Peru: Implications for a rectal microbicide HIV prevention intervention. AIDS Care. Anodyspareunia in men who have sex with men: Prevalence, predictors, consequences and the development of DSM diagnostic criteria. Journal of Public Health Policy. Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya. Sexually Transmitted Diseases. HIV vulnerability of men who have sex with men in developing countries: Horizons Studies, — Public Health Reports. Analyzing qualitative data. Los Angeles, CA: Sage; Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon. Sexually Transmitted Infections. An exploration into anal sexuality. Sexual and Relationship Therapy. The epidemiology of rape and sexual coercion in South Africa: An overview. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. In the dark: The experiences of men who have sex with men with healthcare workers in South African township communities. Alcohol and sexual risk behavior among men who have sex with men in South African township communities. AIDS and Behavior. Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. Constructions of sexuality among gay men in a low-income South African community. Taverns, bars and shebeens: From social silence to social science: Cape Town, South Africa: HSRC Press; You become afraid to tell them that you are gay: Health service utilization by men who have sex with men in South African cities. Sexual difficulties, concerns, and satisfaction in homosexual men: An empirical study with implications for HIV prevention. Anodyspareunia, the unacknowledged sexual dysfunction: A validation study of painful receptive anal intercourse and its psychosexual concomitants in homosexual men. Sexual problems in gay men: An overview of empirical research. Annual Review of Sex Research. Sexual identity, gender, and sexual practices in South African men who have sex with men. Crying Wife forced in to anal. Mandingo rips open white whores asshole. Monica Sexxxton crams a black huge monster in her ass! Hommade Anal Painful Sex. Cute girl dragged and kidnapped in the street!!! Black monster cock filled Anya Akulova's asshole. Pain Anal Compilation - Volume 3 from 3. Morena jovencita cogiendo primera vez verified profile anal cumshot teenager latina brunette riding shaved young ebony cum on ass culito reverse cowgirl doggy style morena small-tits jovencita colegiala chibola ass fuck teenmegaworld..

For example, Mosegi described how what began as a consensual sexual encounter ended in Free hugh cocks painful anal when he withdrew consent during an attempt at intercourse that was painful: And so why did he end up beating you up? Lubricant use The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain.

As Masopha explained, I would say Free hugh cocks painful anal gays, the lubricants are the best things since sliced bread. A national school-based survey in South Africa. International Journal for Equity in Health. BMC Public Health. PLoS One. Link, patterns, and preferences of lubricant use during anal intercourse within male sexual partnerships in Lima, Peru: Implications for a rectal microbicide HIV prevention intervention.

AIDS Care. Anodyspareunia in men who have sex with men: Prevalence, predictors, consequences and the development of DSM diagnostic criteria.

Journal of Public Health Policy. Factors associated with self-reported unprotected anal sex among male sex workers Free hugh cocks painful anal Mombasa, Kenya. Sexually Transmitted Diseases. HIV vulnerability of men who have sex with men in developing countries: Horizons Studies, — Public Health Reports. Analyzing qualitative data.

Aishwarya pussy Watch Video Tamannsex Video. Against the backdrop of the criminalization of homosexuality and high HIV prevalence in many African countries, African MSM face substantial barriers in accessing culturally appropriate and competent sexual health care. In some cases this leads men to self-medicate, seek treatment from unqualified health workers, or not be forthright about their symptoms when seeking treatment Okal et al. African MSM also have restricted access to condom-compatible lubricants Baral et al. Belgian MSM rated the lack of lubrication and of anal foreplay as the most important factors predicting pain during RAI Vansintejan et al. Participants also reported that prevalence and severity of painful RAI decreased as sexual experience increased Vansintejan et al. Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. This ethnographic research, consisting of interviews as well as observations at taverns and with MSM friendship groups, was conducted to lay groundwork for quantitative research with this study population as well as future interventions. Townships are residential areas that were designated for non-whites during the apartheid era; although residential racial segregation ended in , these areas remain almost entirely segregated today. All four of the townships where research was conducted were formerly designated as residential areas for Blacks. Aside from the realities of the township geography and infrastructure, the daily lives of MSM may be impacted by the limited social acceptance of homosexuality in South Africa, which has implications for their safety and access to health care Baral et al. Although not originally an a priori focus of our research, many research participants made reference to painful RAI in their discussions of their sexual experiences with men. Given its implications for HIV risk and protective behaviors, as well as for sexual health, pleasure, and relationships more generally, we felt this topic merited closer examination. In-depth interviews were conducted with 81 Black MSM from four township communities 20 participants each from Atteridgeville, Mamelodi, and Soshanguve, and 21 from Hammanskraal. Biological males who self-identified as Black upon screening, were 20—44 years old, resided in one of the four targeted townships, and who reported oral, anal, or masturbatory sex with at least one male in the preceding year were eligible to participate. Twenty-five participants reported a lifetime history of sexual experience with women and about half of these participants reported current involvement with female sexual partners. Snowball referrals were also made by interview participants. Purposive selection of participants was used to ensure that the sample was diverse in terms of age, sexual orientation self-identification, gender presentation, and choice of sexual partners i. Trained interviewers used a semi-structured guide to conduct interviews that lasted approximately 90 minutes. As is common among South Africans who live in township communities, discussions were sometimes conducted in more than one language, and most other interviews were conducted in a combination of English and Tswana Setswana or Northern Sotho Sepedi. A few interviews were conducted completely in Tswana or Northern Sotho. All interviews were transcribed in full; passages or complete interviews that were not in English were translated during transcription. The interview guide covered topics such as sexual and gender identity, MSM social networks, family and community acceptance, alcohol and drug use, sexual practices including safer sex behaviors, and experiences with HIV testing. Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, First, three coders completed concept-driven coding by independently applying a set of a priori codes to the interview transcripts, using Atlas. Initially, each transcript was coded by two coders, who met to reach consensus on the coding and produce reconciled, coded transcripts 37 of the 81 interview transcripts. After consensus about the coding process was reached, the remaining 44 transcripts were coded by one of three coders. It became clear during the process of concept-driven coding, and upon review of the quotations associated with some of the concept-driven codes e. For purposes of this investigation, a second round of data-driven coding was undertaken in order to organize all the material related to painful anal intercourse in consensual sexual encounters. Data-driven coding was completed by the first author and reviewed by a co-author. Experiences of rape or other sexual violence were excluded from this analysis except in one case where painful RAI precipitated a rape a total of 17 participants disclosed that they were victims of sexual violence. Of those participants who engaged in RAI because it was their exclusive preference, or because they were versatile, nearly all identified as gay. Most of these participants saw themselves as more feminine than masculine. With the exception of one who did not like anal sex, all the participants who identified as transgender or drag queens also reported a preference for RAI. Descriptions of personal experience with painful RAI therefore come primarily from gay-identified MSM in this study, as the straight-identified MSM and the majority with either a bisexual self-identification or bisexual attractions preferred insertive AI only. Table 1 provides a listing and description of all participants who are directly quoted in the following sections. Of all 81 study participants, only those quoted in the text are included in this table. Participants reported on their first same-sex sexual experiences and how old they were at the time. Sixteen participants indicated that their first same-sex sexual experience occurred before the age of 16; 44 participants were aged 16—19; and 17 had their first experiences after age 20; this data was missing from four respondents. 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. More than three-quarters of participants described first same-sex sexual experiences that involved anal intercourse. Participants commonly described these experiences as painful. A smaller group of men described them as both painful and pleasurable. Six participants reported that their first same-sex sexual experience, beyond being painful, involved serious anorectal trauma. Four of these participants reported bleeding during or after the encounter, and one reported having hemorrhoids piles at the time of first RAI. The story shared by Tlotliso exemplified the potential vulnerability of MSM in their first sexual encounters, which could be amplified by the need or desire for secrecy about engaging in same-sex sexual behavior. 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:. So around 11 a. It was pain from behind. It was painful but I ignored it. The pain alerted me to go to the toilet, I felt like defecating. I went to the toilet and defecated, and as I was busy, blood dripped in the toilet. Afterwards I told my friend, and my friend explained to me what was happening. 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. On Monday, when I went to the toilet again, the same thing happened and my mom was at home. When I got there, the doctor told me to climb on the bed and he inspected me and when he was done he told my mother that I am being naughty and that I know what I did and that I will tell her what I did. So my mother asked me what I did and I told her. This quotation illustrates a range of negative outcomes that could possibly have been prevented had Tlotliso received some advance education about how to avoid or address such outcomes. Participants were asked about subsequent same-sex sexual experiences i. Twenty-one participants referred in their interviews to personal experiences with painful RAI, and we focus here on these descriptions. Additional participants made reference to anal sex as painful, though they were not necessarily describing personal experiences i. The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. It gets difficult because you have to tell him what to do, where to penetrate, what not to do, things like that. Participants described other attributions for painful RAI that seemed to arise during the sex act: Several participants reported experiencing pain as a result of anal intercourse that, although consensual, was either too rough, too fast, or too slow. Sizwe shared the following story about a negative sexual experience:. But he was my boyfriend, my steady boyfriend, so like I had to just, you know, end the relationship because of that sex. He was so controlling to me and he wanted whatever he wanted. Lutendo and Tumelo shared similar accounts. The experience, that person he controlled me over and he was just doing it and he was rushed, he was rough and rushed. Interviewers generally did not probe for specifics about the type of lubricants referred to in these instances, however. Although it was the lack of lubricant in the context of sexual encounters that participants discussed in relation to painful RAI, participants also commented more generally on the limited availability of lubricants in their townships. Unlike condoms, which were widely available for free, lubricants generally needed to be purchased at venues located outside the townships such as pharmacies and adult shops. Participants linked alcohol consumption to painful RAI in several ways. RAI was painful to some participants when they were sober, and was less painful when they were drunk. As Dingani explained, in describing how sex differed whether he was sober or drunk:. When a guy is too rough, you can feel the pain and ask him to stop. As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later:. You feel them tomorrow. Finally, a few participants noted that RAI could be painful when their partners were drunk, either because they would have difficulty reaching a climax or became more aggressive. These strategies are discussed in further detail below. A small number of participants used strategies that would not fall into either of these categories. For example, although a larger number of participants had generally discussed alcohol use as a context for painful RAI, two participants reported using alcohol purposefully to prevent the pain associated with RAI. 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. These actions included abstaining from anal intercourse; having non-penetrative sex; and having rules about sex acts or sexual positions one would or would not perform. Dingani explained how he would communicate his boundaries to his sexual partners:. When you are having sex do you negotiate what type of sex you want and do you also give the other person a chance to voice what he wants? Yes, we talk about it first. So I will tell him to think of something. Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis:. When you are with a man would it be clear from the start what type of sex you will have and how is it clear what type of sex you will be having? It depends on the guy, whether he is rough or gentle. If he is rough, you can tell him that he is too rough and you can try a second option. The above example illustrates that boundary-setting might happen not only case-by-case, but from moment to moment, as needed to ensure a pleasurable sexual experience. This example also illuminates the overlapping factors that could structure the experience: Some participants set sexual boundaries specifically related to lubricant use, saying that they would not engage in anal intercourse if lubricant was not available. As Kabelo also explained:. Sexual boundaries were not always respected, however, particularly from sexually abusive partners. For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful:. Some other guy, we agreed to each other, we went to his place and then he was beating me because, how can I put it? He could not like penetrate it to me. And then he was busy like trying to force himself on me. Because I was telling him he could not enter me…He started to beat me and hit me with a bottle…I was scared of him…He tried to force himself on me. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about pain during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants raised this issue themselves. Despite these limitations, the fact that participants in this study discussed painful RAI in relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared for their first same-sex sexual experiences. In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Kalichman, ; painful RAI can occur in the context of heterosexual sexual encounters, as well. Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI. Crying Wife forced in to anal. Mandingo rips open white whores asshole. Monica Sexxxton crams a black huge monster in her ass! Hommade Anal Painful Sex. Cute girl dragged and kidnapped in the street!!! Black monster cock filled Anya Akulova's asshole. Pain Anal Compilation - Volume 3 from 3. Morena jovencita cogiendo primera vez verified profile anal cumshot teenager latina brunette riding shaved young ebony cum on ass culito reverse cowgirl doggy style morena small-tits jovencita colegiala chibola ass fuck teenmegaworld..

Los Angeles, CA: Sage; Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon. Sexually Transmitted Free hugh cocks painful anal. An exploration into anal sexuality. Sexual and Relationship Therapy. The epidemiology of rape and sexual coercion in South Africa: An overview. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Free hugh cocks painful anal. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities.

In the dark: The experiences of men who have sex with men with healthcare workers in South African township communities. Alcohol and sexual risk behavior among men link have sex with men in South African township communities. AIDS and Behavior. Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey.

Constructions of sexuality among gay men in a low-income South African community. Taverns, bars and shebeens: From social silence to social science: Cape Town, South Africa: HSRC Press; You become afraid to tell them that you are gay: Health service utilization by men who have sex with men in South African cities.

Sexual difficulties, concerns, and satisfaction in homosexual men: An empirical study with implications for HIV prevention. Anodyspareunia, the unacknowledged sexual dysfunction: A validation study of painful receptive anal intercourse Click at this page its psychosexual concomitants in homosexual men.

Hot sexii Watch Video Hotspot peterhead. In-depth interviews were conducted with 81 Black MSM ages 20—39 years who were purposively recruited from four townships. The semi-structured interviews addressed sexual behavior and identity, alcohol use, and safer sex. Pain during RAI was brought up by many participants without specific prompting from the interviewer. Analysis of the interview transcripts revealed that pain was a common feature of first RAI experiences but was not limited to first-time experiences. The participants attributed pain during RAI to partner characteristics, interpersonal dynamics, lack of lubricant, and alcohol use or non-use. The main strategies participants used to address pain during RAI were setting sexual boundaries and lubricant use; a small number of participants reported purposefully consuming alcohol to prevent the pain associated with RAI. Pain can occur during anal penetration when the external anal sphincter is not relaxed; because the anus does not self-lubricate, lubricating substances are also needed to reduce pain from friction Hollows, Other causes of pain during anal penetration may be sexually transmitted infections STIs such as herpes, or other anal health issues such as fissures and hemorrhoids Hollows, Experiences of pain during RAI are not uncommon and vary on different dimensions e. Pain during RAI may be either situational i. In a sample of primarily white, gay-identified men in the U. Such symptoms could result from or precede incidents of painful RAI. In the African context, factors that are unique vulnerabilities for MSM elevate the issue of painful RAI from one of individual to public health significance. Against the backdrop of the criminalization of homosexuality and high HIV prevalence in many African countries, African MSM face substantial barriers in accessing culturally appropriate and competent sexual health care. In some cases this leads men to self-medicate, seek treatment from unqualified health workers, or not be forthright about their symptoms when seeking treatment Okal et al. African MSM also have restricted access to condom-compatible lubricants Baral et al. Belgian MSM rated the lack of lubrication and of anal foreplay as the most important factors predicting pain during RAI Vansintejan et al. Participants also reported that prevalence and severity of painful RAI decreased as sexual experience increased Vansintejan et al. Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. This ethnographic research, consisting of interviews as well as observations at taverns and with MSM friendship groups, was conducted to lay groundwork for quantitative research with this study population as well as future interventions. Townships are residential areas that were designated for non-whites during the apartheid era; although residential racial segregation ended in , these areas remain almost entirely segregated today. All four of the townships where research was conducted were formerly designated as residential areas for Blacks. Aside from the realities of the township geography and infrastructure, the daily lives of MSM may be impacted by the limited social acceptance of homosexuality in South Africa, which has implications for their safety and access to health care Baral et al. Although not originally an a priori focus of our research, many research participants made reference to painful RAI in their discussions of their sexual experiences with men. Given its implications for HIV risk and protective behaviors, as well as for sexual health, pleasure, and relationships more generally, we felt this topic merited closer examination. In-depth interviews were conducted with 81 Black MSM from four township communities 20 participants each from Atteridgeville, Mamelodi, and Soshanguve, and 21 from Hammanskraal. Biological males who self-identified as Black upon screening, were 20—44 years old, resided in one of the four targeted townships, and who reported oral, anal, or masturbatory sex with at least one male in the preceding year were eligible to participate. Twenty-five participants reported a lifetime history of sexual experience with women and about half of these participants reported current involvement with female sexual partners. Snowball referrals were also made by interview participants. Purposive selection of participants was used to ensure that the sample was diverse in terms of age, sexual orientation self-identification, gender presentation, and choice of sexual partners i. Trained interviewers used a semi-structured guide to conduct interviews that lasted approximately 90 minutes. As is common among South Africans who live in township communities, discussions were sometimes conducted in more than one language, and most other interviews were conducted in a combination of English and Tswana Setswana or Northern Sotho Sepedi. A few interviews were conducted completely in Tswana or Northern Sotho. All interviews were transcribed in full; passages or complete interviews that were not in English were translated during transcription. The interview guide covered topics such as sexual and gender identity, MSM social networks, family and community acceptance, alcohol and drug use, sexual practices including safer sex behaviors, and experiences with HIV testing. Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, First, three coders completed concept-driven coding by independently applying a set of a priori codes to the interview transcripts, using Atlas. Initially, each transcript was coded by two coders, who met to reach consensus on the coding and produce reconciled, coded transcripts 37 of the 81 interview transcripts. After consensus about the coding process was reached, the remaining 44 transcripts were coded by one of three coders. It became clear during the process of concept-driven coding, and upon review of the quotations associated with some of the concept-driven codes e. For purposes of this investigation, a second round of data-driven coding was undertaken in order to organize all the material related to painful anal intercourse in consensual sexual encounters. Data-driven coding was completed by the first author and reviewed by a co-author. Experiences of rape or other sexual violence were excluded from this analysis except in one case where painful RAI precipitated a rape a total of 17 participants disclosed that they were victims of sexual violence. Of those participants who engaged in RAI because it was their exclusive preference, or because they were versatile, nearly all identified as gay. Most of these participants saw themselves as more feminine than masculine. With the exception of one who did not like anal sex, all the participants who identified as transgender or drag queens also reported a preference for RAI. Descriptions of personal experience with painful RAI therefore come primarily from gay-identified MSM in this study, as the straight-identified MSM and the majority with either a bisexual self-identification or bisexual attractions preferred insertive AI only. Table 1 provides a listing and description of all participants who are directly quoted in the following sections. Of all 81 study participants, only those quoted in the text are included in this table. Participants reported on their first same-sex sexual experiences and how old they were at the time. Sixteen participants indicated that their first same-sex sexual experience occurred before the age of 16; 44 participants were aged 16—19; and 17 had their first experiences after age 20; this data was missing from four respondents. 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. More than three-quarters of participants described first same-sex sexual experiences that involved anal intercourse. Participants commonly described these experiences as painful. A smaller group of men described them as both painful and pleasurable. Six participants reported that their first same-sex sexual experience, beyond being painful, involved serious anorectal trauma. Four of these participants reported bleeding during or after the encounter, and one reported having hemorrhoids piles at the time of first RAI. The story shared by Tlotliso exemplified the potential vulnerability of MSM in their first sexual encounters, which could be amplified by the need or desire for secrecy about engaging in same-sex sexual behavior. 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:. So around 11 a. It was pain from behind. It was painful but I ignored it. The pain alerted me to go to the toilet, I felt like defecating. I went to the toilet and defecated, and as I was busy, blood dripped in the toilet. Afterwards I told my friend, and my friend explained to me what was happening. 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. On Monday, when I went to the toilet again, the same thing happened and my mom was at home. When I got there, the doctor told me to climb on the bed and he inspected me and when he was done he told my mother that I am being naughty and that I know what I did and that I will tell her what I did. So my mother asked me what I did and I told her. This quotation illustrates a range of negative outcomes that could possibly have been prevented had Tlotliso received some advance education about how to avoid or address such outcomes. Participants were asked about subsequent same-sex sexual experiences i. Twenty-one participants referred in their interviews to personal experiences with painful RAI, and we focus here on these descriptions. Additional participants made reference to anal sex as painful, though they were not necessarily describing personal experiences i. The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. It gets difficult because you have to tell him what to do, where to penetrate, what not to do, things like that. Participants described other attributions for painful RAI that seemed to arise during the sex act: Several participants reported experiencing pain as a result of anal intercourse that, although consensual, was either too rough, too fast, or too slow. Sizwe shared the following story about a negative sexual experience:. But he was my boyfriend, my steady boyfriend, so like I had to just, you know, end the relationship because of that sex. He was so controlling to me and he wanted whatever he wanted. Lutendo and Tumelo shared similar accounts. The experience, that person he controlled me over and he was just doing it and he was rushed, he was rough and rushed. Interviewers generally did not probe for specifics about the type of lubricants referred to in these instances, however. Although it was the lack of lubricant in the context of sexual encounters that participants discussed in relation to painful RAI, participants also commented more generally on the limited availability of lubricants in their townships. Unlike condoms, which were widely available for free, lubricants generally needed to be purchased at venues located outside the townships such as pharmacies and adult shops. Participants linked alcohol consumption to painful RAI in several ways. RAI was painful to some participants when they were sober, and was less painful when they were drunk. As Dingani explained, in describing how sex differed whether he was sober or drunk:. When a guy is too rough, you can feel the pain and ask him to stop. As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later:. You feel them tomorrow. Finally, a few participants noted that RAI could be painful when their partners were drunk, either because they would have difficulty reaching a climax or became more aggressive. These strategies are discussed in further detail below. A small number of participants used strategies that would not fall into either of these categories. For example, although a larger number of participants had generally discussed alcohol use as a context for painful RAI, two participants reported using alcohol purposefully to prevent the pain associated with RAI. 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. These actions included abstaining from anal intercourse; having non-penetrative sex; and having rules about sex acts or sexual positions one would or would not perform. Dingani explained how he would communicate his boundaries to his sexual partners:. When you are having sex do you negotiate what type of sex you want and do you also give the other person a chance to voice what he wants? Yes, we talk about it first. So I will tell him to think of something. Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis:. When you are with a man would it be clear from the start what type of sex you will have and how is it clear what type of sex you will be having? It depends on the guy, whether he is rough or gentle. If he is rough, you can tell him that he is too rough and you can try a second option. The above example illustrates that boundary-setting might happen not only case-by-case, but from moment to moment, as needed to ensure a pleasurable sexual experience. This example also illuminates the overlapping factors that could structure the experience: Some participants set sexual boundaries specifically related to lubricant use, saying that they would not engage in anal intercourse if lubricant was not available. As Kabelo also explained:. Sexual boundaries were not always respected, however, particularly from sexually abusive partners. For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful:. Some other guy, we agreed to each other, we went to his place and then he was beating me because, how can I put it? He could not like penetrate it to me. And then he was busy like trying to force himself on me. Because I was telling him he could not enter me…He started to beat me and hit me with a bottle…I was scared of him…He tried to force himself on me. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Hommade Anal Painful Sex. Cute girl dragged and kidnapped in the street!!! Black monster cock filled Anya Akulova's asshole. Pain Anal Compilation - Volume 3 from 3. Morena jovencita cogiendo primera vez verified profile anal cumshot teenager latina brunette riding shaved young ebony cum on ass culito reverse cowgirl doggy style morena small-tits jovencita colegiala chibola ass fuck teenmegaworld. Our Friend Watches Us Fuck In a Vegas Hotel verified profile sex creampie riding doggystyle big ass family missionary big tits lips vegas pawg girls gone wild camel toe fat pussy step sis edc. Ads by TrafficFactory. Type Straight Gay Shemale..

Sexual problems in gay men: An overview of empirical research. Mandingo rips open white whores asshole. Monica Sexxxton crams a black huge monster in her ass! Hommade Anal Painful Sex. Cute girl dragged and kidnapped in the street!!! Black monster cock filled Anya Akulova's asshole. Pain Anal Compilation - Volume 3 from 3. Morena jovencita cogiendo primera vez verified profile anal cumshot teenager latina brunette riding shaved young ebony cum on ass culito reverse cowgirl doggy style morena small-tits Free hugh cocks painful anal colegiala chibola article source fuck teenmegaworld.

Our Friend Watches Us Fuck In a Vegas Hotel verified profile sex creampie riding doggystyle big ass family missionary big tits lips vegas pawg girls gone wild camel toe fat pussy step sis edc. Cerita sex perkosa istri orang. In-depth interviews were conducted with Free hugh cocks painful anal Black MSM ages 20—39 years who were purposively recruited from four townships.

The semi-structured interviews addressed sexual behavior and identity, alcohol use, and Free hugh cocks painful anal sex.

Military fuck Watch Video Filate sexually. Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis:. When you are with a man would it be clear from the start what type of sex you will have and how is it clear what type of sex you will be having? It depends on the guy, whether he is rough or gentle. If he is rough, you can tell him that he is too rough and you can try a second option. The above example illustrates that boundary-setting might happen not only case-by-case, but from moment to moment, as needed to ensure a pleasurable sexual experience. This example also illuminates the overlapping factors that could structure the experience: Some participants set sexual boundaries specifically related to lubricant use, saying that they would not engage in anal intercourse if lubricant was not available. As Kabelo also explained:. Sexual boundaries were not always respected, however, particularly from sexually abusive partners. For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful:. Some other guy, we agreed to each other, we went to his place and then he was beating me because, how can I put it? He could not like penetrate it to me. And then he was busy like trying to force himself on me. Because I was telling him he could not enter me…He started to beat me and hit me with a bottle…I was scared of him…He tried to force himself on me. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about pain during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants raised this issue themselves. Despite these limitations, the fact that participants in this study discussed painful RAI in relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared for their first same-sex sexual experiences. In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Kalichman, ; painful RAI can occur in the context of heterosexual sexual encounters, as well. Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI. 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. The participants in this study reported that while condoms are widely available for purchase or for free , lubricants are more difficult to obtain, as they are offered in fewer places and are only rarely made available for free. The cost of commercial lubricants to the participants in our study, many of whom were unemployed, was considered expensive. There are also a limited number of places to which MSM can be referred for sexual health care e. Efforts to capacitate local service providers and community-based organizations to address the sexual health needs of MSM will therefore be essential. Capacitating health care workers should include skills-building around non-stigmatizing clinical care of MSM and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity. 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. Putting the spotlight on this issue may yield added and renewed health and wellness benefits to individual men, but is also potentially an important part of HIV and STI prevention efforts focused on this population. Theo Sandfort, Ph. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Robert H. Remien, Ph. We wish to thank OUT Well-being, the communities that partnered with us in conducting this research, and the study 28 participants for their contributions. We also thank study staff at all participating institutions for their work and dedication. Arch Sex Behav. Author manuscript; available in PMC Feb 1. Kate L. Collier , 1 Theo G. Sandfort , 1 Vasu Reddy , 2, 3 and Tim Lane 4. Theo G. Find articles by Vasu Reddy. Find articles by Tim Lane. Copyright notice. The publisher's final edited version of this article is available at Arch Sex Behav. See other articles in PMC that cite the published article. The Present Study Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. Analysis Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, Table 1 Characteristics of Study Participants Pseudonym. Open in a separate window. First same-sex sexual experiences Participants reported on their first same-sex sexual experiences and how old they were at the time. 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: As Tlotliso goes on to explain, he eventually needed to seek medical intervention: Attributions for Painful Receptive Anal Intercourse Participants were asked about subsequent same-sex sexual experiences i. Partner characteristics The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. Interpersonal dynamics Participants described other attributions for painful RAI that seemed to arise during the sex act: Sizwe shared the following story about a negative sexual experience: Okay, what was painful about the sex? Was it something that you felt needed to be reported? And did you tell him? Alcohol consumption Participants linked alcohol consumption to painful RAI in several ways. As Dingani explained, in describing how sex differed whether he was sober or drunk: As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later: 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. Dingani explained how he would communicate his boundaries to his sexual partners: You speak about frozen; which other positions do you negotiate? Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis: How big it is…? And most of the time they agree? Yes, they agree. As Kabelo also explained: Have they done it by force to you without lubricant? For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful: And so why did he end up beating you up? Lubricant use The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained, I would say to gays, the lubricants are the best things since sliced bread. A national school-based survey in South Africa. International Journal for Equity in Health. BMC Public Health. PLoS One. Frequency, patterns, and preferences of lubricant use during anal intercourse within male sexual partnerships in Lima, Peru: Implications for a rectal microbicide HIV prevention intervention. AIDS Care. Anodyspareunia in men who have sex with men: Prevalence, predictors, consequences and the development of DSM diagnostic criteria. Journal of Public Health Policy. Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya. Sexually Transmitted Diseases. HIV vulnerability of men who have sex with men in developing countries: Horizons Studies, — Public Health Reports. Analyzing qualitative data. Los Angeles, CA: Sage; Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon. Sexually Transmitted Infections. An exploration into anal sexuality. Sexual and Relationship Therapy. The epidemiology of rape and sexual coercion in South Africa: An overview. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. In the dark: The experiences of men who have sex with men with healthcare workers in South African township communities. Alcohol and sexual risk behavior among men who have sex with men in South African township communities. AIDS and Behavior. Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Young people's sexual health in South Africa: Hommade Anal Painful Sex. Cute girl dragged and kidnapped in the street!!! Black monster cock filled Anya Akulova's asshole. Pain Anal Compilation - Volume 3 from 3. Morena jovencita cogiendo primera vez verified profile anal cumshot teenager latina brunette riding shaved young ebony cum on ass culito reverse cowgirl doggy style morena small-tits jovencita colegiala chibola ass fuck teenmegaworld. Our Friend Watches Us Fuck In a Vegas Hotel verified profile sex creampie riding doggystyle big ass family missionary big tits lips vegas pawg girls gone wild camel toe fat pussy step sis edc. Ads by TrafficFactory. Type Straight Gay Shemale..

Pain during RAI was brought up by many participants without specific prompting from the interviewer. Analysis of the interview transcripts revealed that pain was a common feature of first RAI experiences but was not limited to first-time experiences. The participants attributed pain during RAI to partner characteristics, interpersonal dynamics, lack of lubricant, and alcohol use or non-use. The main strategies participants used to address pain during RAI were setting sexual boundaries and lubricant use; a small number of participants reported purposefully consuming alcohol to prevent the pain associated with RAI.

Pain can occur during anal penetration when the external anal sphincter is not relaxed; because the anus does Free hugh cocks painful anal self-lubricate, lubricating substances are also needed to reduce pain from friction Hollows, Other causes of pain during anal penetration may be sexually transmitted infections STIs such as herpes, or Free hugh cocks painful anal anal health issues such as fissures and hemorrhoids Hollows, Experiences of pain during RAI are not uncommon and vary on different dimensions e.

Free hugh cocks painful anal during RAI may be either situational i.

Free hugh cocks painful anal

In a sample of primarily white, gay-identified men in the U. Such symptoms could result from or precede Free hugh cocks painful anal of painful RAI. In the African context, factors that are unique vulnerabilities for MSM elevate the issue of painful RAI from one of individual to public health significance. Against the backdrop of the criminalization of homosexuality and high HIV prevalence Free hugh cocks painful anal many African countries, African MSM face substantial barriers Free hugh cocks painful anal accessing culturally appropriate and competent sexual health care.

In some cases this leads men to self-medicate, seek treatment from unqualified health workers, or not be forthright about their symptoms when seeking treatment Okal et al. African MSM also have restricted access to condom-compatible lubricants Baral et al. Belgian MSM rated the lack of lubrication and of anal foreplay as the most important factors predicting pain during RAI Vansintejan et al.

Participants also reported that prevalence and severity of painful RAI decreased as sexual experience increased Vansintejan et al. Data for this Wonen tied up sex were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities.

This ethnographic research, consisting of interviews as well as observations at taverns and with MSM friendship groups, was conducted to lay groundwork for quantitative research with this study population as well as future interventions.

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Townships are residential areas that were designated for non-whites during the apartheid era; although residential racial segregation ended inthese areas remain almost entirely segregated today.

All four of the townships where research was conducted were formerly designated as residential areas for Blacks. Aside from the realities of the township geography and infrastructure, the daily lives of MSM may be impacted by the Free hugh cocks painful anal social acceptance of homosexuality in Free hugh cocks painful anal Africa, which has implications for their safety and access to health care Baral et al.

Although not originally an a priori focus of our research, many research participants made reference to painful RAI in their discussions of their sexual experiences with men.

Given its implications for HIV risk and protective behaviors, as well as for sexual health, pleasure, and relationships more generally, we felt this topic merited closer examination. In-depth interviews were conducted with 81 Black MSM from four township communities 20 Free hugh cocks painful anal each from Atteridgeville, Mamelodi, and Soshanguve, and 21 from Hammanskraal. Biological males who self-identified as Black upon screening, were 20—44 years old, resided in one of the four targeted townships, and who reported oral, anal, or masturbatory sex with at least one male in the preceding year were eligible to participate.

Twenty-five participants reported a lifetime history of sexual experience with women and about half of these participants reported current Free hugh cocks painful anal with female sexual partners. Snowball referrals were also made by interview participants. Purposive selection of participants was used to ensure that the sample was diverse in terms of age, sexual orientation self-identification, gender presentation, and choice of sexual partners i.

Trained interviewers used a semi-structured guide to conduct interviews that lasted approximately 90 minutes. As is common among South Africans who live in township communities, discussions were sometimes conducted in more than one language, and most other interviews were conducted click to see more a combination of English and Tswana Setswana or Northern Sotho Sepedi.

A few interviews were conducted completely in Tswana or Northern Sotho. All interviews were transcribed in full; passages or complete interviews that were not in English were translated during transcription. The interview guide covered topics such as sexual and gender identity, MSM social networks, family and community acceptance, alcohol and drug use, sexual practices including safer sex behaviors, and experiences with HIV testing.

Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, First, three coders completed concept-driven coding by independently applying a set of a priori codes to the interview transcripts, using Atlas.

Initially, each transcript was coded by two coders, who met to reach consensus on the coding and produce reconciled, coded transcripts 37 of the 81 interview transcripts. After consensus about the coding process was reached, the remaining 44 transcripts were coded by one of three coders.

It became Free hugh cocks painful anal during the process of concept-driven coding, and upon review of the quotations associated with some of the concept-driven codes e.

For purposes of this investigation, a second round of data-driven coding was undertaken in order to organize all the material related to painful anal intercourse in consensual sexual encounters.

Data-driven coding was completed by the first author and reviewed by a co-author. Experiences of rape or other sexual violence were excluded from this analysis except in one case where painful RAI precipitated a rape a total of 17 participants disclosed that they were victims of sexual violence. Of those participants who engaged in RAI because it was their exclusive preference, or because they were versatile, nearly all identified as gay. Most of these participants saw themselves as more feminine than masculine.

With the exception of one who Free hugh cocks painful anal not like anal sex, all the participants who Free hugh cocks painful anal as transgender or drag queens also reported a preference for RAI. Descriptions of personal experience with painful RAI therefore come primarily from gay-identified Free hugh cocks painful anal in see more study, as the straight-identified MSM and the majority with either a bisexual self-identification or bisexual attractions preferred insertive AI only.

Table 1 provides a listing and description of all participants who are directly quoted in the following Free hugh cocks painful anal.

How long after sex genital herpes

Of all 81 study participants, only those quoted in Free hugh cocks painful anal text are included in this table. Participants reported on their first Free hugh cocks painful anal sexual experiences and how old they were at the time. Sixteen participants indicated that their first same-sex sexual experience occurred before the age of 16; 44 participants were aged 16—19; and 17 had their first experiences after age 20; this data was missing from four respondents.

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.

Read article than three-quarters of participants described first same-sex sexual experiences that involved anal intercourse. Participants commonly described these experiences as painful.

A smaller group of men described them as both painful and pleasurable.

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Six participants reported that their first click to see more sexual experience, beyond being painful, involved serious anorectal trauma. Four of these participants reported bleeding during or after the encounter, and one reported having hemorrhoids piles at the time of first RAI. The story shared by Tlotliso Free hugh cocks painful anal the potential vulnerability of MSM in their first sexual encounters, which could be amplified by the need or desire for secrecy about engaging in same-sex sexual behavior.

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:. So around 11 a. It was pain from behind. It was painful but I ignored it. The pain alerted me to go to the toilet, I felt like defecating. I went to the toilet and defecated, and as I was busy, blood dripped Free hugh cocks painful anal the toilet.

Afterwards I told my friend, and my friend explained to me what was happening. After some time I felt better and I took a bath Free hugh cocks painful anal came home; when I got there I told myself that the pain would not happen again. On Monday, when I went to the toilet again, the same thing happened and my mom was at home.

big cock painful

When I got there, the doctor told me to climb on the bed and he inspected me and when he was done he told my mother that I am being naughty and Free hugh cocks painful anal I know what I did and that I will tell her what I did. So my mother asked me what I did and I told her. This quotation illustrates a range of negative outcomes that could possibly have been prevented had Tlotliso received some advance education about how to avoid or address such outcomes.

Participants were asked about subsequent same-sex sexual experiences i. Twenty-one participants referred in their interviews to personal experiences with painful RAI, and we focus here on these descriptions.

Additional participants made reference to anal sex as painful, though they were not necessarily describing personal experiences i. The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. It gets difficult Free hugh cocks painful anal you have to tell him what to do, where to penetrate, what not to do, things like that.

Participants described other attributions for painful RAI that seemed to arise during the sex act: Several participants reported experiencing pain as a result of anal intercourse that, although consensual, was either too rough, too fast, or too slow. Sizwe shared the following story about a negative sexual experience:.

But he was my boyfriend, my steady boyfriend, so like I had to just, you know, end the relationship because of that sex. He was so controlling to me and he wanted whatever he wanted. Lutendo and Tumelo shared similar accounts. The experience, that person he controlled me over and Free hugh cocks painful anal was just doing it and he was rushed, he was rough and rushed. Interviewers generally did not probe for specifics about the type of lubricants referred to in these instances, however.

Although it was the lack of lubricant in the context of sexual encounters that participants discussed in relation to painful RAI, participants also commented more generally on the limited availability of lubricants in their townships.

Unlike condoms, which were widely available for free, lubricants generally needed to be purchased at venues Free hugh cocks painful anal outside the townships such as pharmacies and adult shops. Participants linked alcohol consumption to painful RAI in several ways. RAI was painful to some participants when they were sober, and read more less painful when they were drunk.

As Dingani explained, in describing how sex differed whether Free hugh cocks painful anal was sober or drunk:. Free hugh cocks painful anal a guy is too rough, you can feel the pain and ask him to stop. As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later:. You feel them tomorrow. Finally, a few participants noted that RAI could be painful when their partners were drunk, either because they would have difficulty reaching a climax or became more aggressive.

These strategies are discussed in further detail below.

Xxx Interiorxxx Watch Video Babji Sexy. Because I was telling him he could not enter me…He started to beat me and hit me with a bottle…I was scared of him…He tried to force himself on me. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about pain during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants raised this issue themselves. Despite these limitations, the fact that participants in this study discussed painful RAI in relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared for their first same-sex sexual experiences. In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Kalichman, ; painful RAI can occur in the context of heterosexual sexual encounters, as well. Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI. 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. The participants in this study reported that while condoms are widely available for purchase or for free , lubricants are more difficult to obtain, as they are offered in fewer places and are only rarely made available for free. The cost of commercial lubricants to the participants in our study, many of whom were unemployed, was considered expensive. There are also a limited number of places to which MSM can be referred for sexual health care e. Efforts to capacitate local service providers and community-based organizations to address the sexual health needs of MSM will therefore be essential. Capacitating health care workers should include skills-building around non-stigmatizing clinical care of MSM and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity. 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. Putting the spotlight on this issue may yield added and renewed health and wellness benefits to individual men, but is also potentially an important part of HIV and STI prevention efforts focused on this population. Theo Sandfort, Ph. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Robert H. Remien, Ph. We wish to thank OUT Well-being, the communities that partnered with us in conducting this research, and the study 28 participants for their contributions. We also thank study staff at all participating institutions for their work and dedication. Arch Sex Behav. Author manuscript; available in PMC Feb 1. Kate L. Collier , 1 Theo G. Sandfort , 1 Vasu Reddy , 2, 3 and Tim Lane 4. Theo G. Find articles by Vasu Reddy. Find articles by Tim Lane. Copyright notice. The publisher's final edited version of this article is available at Arch Sex Behav. See other articles in PMC that cite the published article. The Present Study Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. Analysis Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, Table 1 Characteristics of Study Participants Pseudonym. Open in a separate window. First same-sex sexual experiences Participants reported on their first same-sex sexual experiences and how old they were at the time. 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: As Tlotliso goes on to explain, he eventually needed to seek medical intervention: Attributions for Painful Receptive Anal Intercourse Participants were asked about subsequent same-sex sexual experiences i. Partner characteristics The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. Interpersonal dynamics Participants described other attributions for painful RAI that seemed to arise during the sex act: Sizwe shared the following story about a negative sexual experience: Okay, what was painful about the sex? Was it something that you felt needed to be reported? And did you tell him? Alcohol consumption Participants linked alcohol consumption to painful RAI in several ways. As Dingani explained, in describing how sex differed whether he was sober or drunk: As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later: 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. Dingani explained how he would communicate his boundaries to his sexual partners: You speak about frozen; which other positions do you negotiate? Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis: How big it is…? And most of the time they agree? Yes, they agree. As Kabelo also explained: Have they done it by force to you without lubricant? For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful: And so why did he end up beating you up? Lubricant use The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained, I would say to gays, the lubricants are the best things since sliced bread. A national school-based survey in South Africa. International Journal for Equity in Health. BMC Public Health. PLoS One. Frequency, patterns, and preferences of lubricant use during anal intercourse within male sexual partnerships in Lima, Peru: Implications for a rectal microbicide HIV prevention intervention. AIDS Care. Anodyspareunia in men who have sex with men: Prevalence, predictors, consequences and the development of DSM diagnostic criteria. Journal of Public Health Policy. Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya. Sexually Transmitted Diseases. HIV vulnerability of men who have sex with men in developing countries: Horizons Studies, — Public Health Reports. Analyzing qualitative data. Los Angeles, CA: Sage; Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon. Sexually Transmitted Infections. An exploration into anal sexuality. Sexual and Relationship Therapy. The epidemiology of rape and sexual coercion in South Africa: An overview. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. In the dark: The experiences of men who have sex with men with healthcare workers in South African township communities. Alcohol and sexual risk behavior among men who have sex with men in South African township communities. AIDS and Behavior. Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. Constructions of sexuality among gay men in a low-income South African community. Taverns, bars and shebeens: From social silence to social science: Cape Town, South Africa: HSRC Press; You become afraid to tell them that you are gay: Health service utilization by men who have sex with men in South African cities. Sexual difficulties, concerns, and satisfaction in homosexual men: An empirical study with implications for HIV prevention. Anodyspareunia, the unacknowledged sexual dysfunction: A validation study of painful receptive anal intercourse and its psychosexual concomitants in homosexual men. Sexual problems in gay men: Warning, Explicit Content. Trinity gets fucked with a huge cock. Restrained bondage sub fucked by black master. Giant black cock anal makes bitch scream - MP4 P. Making him the first anal to the beautiful culona my neighbor screaming as tasty round ass well dril. Rough Anal Pain: Crying Wife forced in to anal. Mandingo rips open white whores asshole..

A small number of participants used strategies that would not fall into either of these categories. For example, although a larger number of participants had generally discussed alcohol use as a context for painful RAI, two participants reported using alcohol purposefully to prevent the pain associated with RAI. Free hugh cocks painful anal participants described setting personal boundaries regarding what here would and would not Free hugh cocks painful anal sexually as a response to experiences of painful RAI and to avoid anal pain.

These actions included abstaining from anal intercourse; having non-penetrative sex; and having rules about sex acts or sexual positions one would or would not perform.

Porn guns Watch Video Gangly Xxx. The above example illustrates that boundary-setting might happen not only case-by-case, but from moment to moment, as needed to ensure a pleasurable sexual experience. This example also illuminates the overlapping factors that could structure the experience: Some participants set sexual boundaries specifically related to lubricant use, saying that they would not engage in anal intercourse if lubricant was not available. As Kabelo also explained:. Sexual boundaries were not always respected, however, particularly from sexually abusive partners. For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful:. Some other guy, we agreed to each other, we went to his place and then he was beating me because, how can I put it? He could not like penetrate it to me. And then he was busy like trying to force himself on me. Because I was telling him he could not enter me…He started to beat me and hit me with a bottle…I was scared of him…He tried to force himself on me. And then I was like, I became relaxed anyway for him to do his job. The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained,. I would say to gays, the lubricants are the best things since sliced bread. Like initially the sex was painful and like it was unbearable, and there were cuts and there was this and there was this. But because of the lube, then the sex it is more easy and bearable I think. Use of commercially available water-based lubricants such as KY Jelly, Durex Play, and Assegai, was most commonly reported. Some participants reported using oil-based lubricants such as jojoba or baby oil and Vaseline; Remicaine gel which contains lidocaine ; plain yogurt; and saliva. For Lesedi, such alternative lubricants were used when commercial lubricants were unavailable: Pain reduction and heightened sexual pleasure were cited as reasons why it was important to use lubricants with condoms. 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. Mareka also referred to the ability of lubricants to both increase comfort during RAI and prevent condom failure: Because I have experienced that the condom—it breaks when you are not using lubrication. Participants attributed painful RAI to various factors and coped with it in different ways, but there were some clear commonalities in their descriptions. The ways in which these men are already coping with this issue also suggest several opportunities for effective sexual health and HIV prevention educational interventions. Their responses to painful RAI can also be optimized so that they yield the greatest health benefits i. This experience differential in some cases led to intercourse that was painful for the receptive partner. MSM engaging in RAI therefore may have an important role as far as expressing their preferences to partners during anal sex; many were quite capable of articulating their likes and dislikes to the study interviewers and could potentially be empowered to do the same during sexual encounters. Gendered power dynamics appear to play an important role, but further study is needed to better understand the way in which such dynamics shape sexual encounters and relationships. Although we make comparisons to other studies with some caution, given that participants in this study were not asked directly about painful RAI, we note that no participants in this study reported limiting their behavior to insertive anal intercourse in response to pain in the receptive role, although this has been found among MSM in the U. 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. A few studies have considered the relationship between sexual role preferences and gender expression in MSM e. Several strengths and limitations of this study should be noted. Given the sampling approach, the participants in this study are not necessarily representative of Black South African MSM, and findings are not generalizable to other populations of MSM. However, more feminine, gay-identifying MSM were best represented in the sample and it was their voices that were dominant on the issue of painful RAI; the perspectives of MSM engaging in insertive AI should be solicited as part of future studies of this topic. There are some additional limitations inherent in the method of assessment and the assessments that were utilized. Direct questions about pain during anal intercourse were not part of the interview guide used in this study, and interviewers did not have specific guidance on how to probe when participants raised this issue themselves. Despite these limitations, the fact that participants in this study discussed painful RAI in relation to sexual practices and decisions without direct questioning by the study interviewers, further suggests it is an issue that many MSM prioritize. One way to address these conditions is with targeted sexual health education and services. First, MSM should be better prepared for their first same-sex sexual experiences. In South African townships, where gay community spaces are non-existent Osmand et al. 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. Discussion of anal sex within sex education programming for adolescents is further warranted by its potential significance in HIV transmission among heterosexuals in South Africa Kalichman, ; painful RAI can occur in the context of heterosexual sexual encounters, as well. Education regarding effective communication techniques in the context of sexual relationships is also important. Participants who were able to exert or share control in sexual situations were best able to avoid the experience of painful RAI. 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. The participants in this study reported that while condoms are widely available for purchase or for free , lubricants are more difficult to obtain, as they are offered in fewer places and are only rarely made available for free. The cost of commercial lubricants to the participants in our study, many of whom were unemployed, was considered expensive. There are also a limited number of places to which MSM can be referred for sexual health care e. Efforts to capacitate local service providers and community-based organizations to address the sexual health needs of MSM will therefore be essential. Capacitating health care workers should include skills-building around non-stigmatizing clinical care of MSM and strengthening practices around patient confidentiality to avoid, among other things, involuntary disclosure of same-sex sexual behaviors or sexual minority identity. 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. Putting the spotlight on this issue may yield added and renewed health and wellness benefits to individual men, but is also potentially an important part of HIV and STI prevention efforts focused on this population. Theo Sandfort, Ph. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. Robert H. Remien, Ph. We wish to thank OUT Well-being, the communities that partnered with us in conducting this research, and the study 28 participants for their contributions. We also thank study staff at all participating institutions for their work and dedication. Arch Sex Behav. Author manuscript; available in PMC Feb 1. Kate L. Collier , 1 Theo G. Sandfort , 1 Vasu Reddy , 2, 3 and Tim Lane 4. Theo G. Find articles by Vasu Reddy. Find articles by Tim Lane. Copyright notice. The publisher's final edited version of this article is available at Arch Sex Behav. See other articles in PMC that cite the published article. The Present Study Data for this study were from an ethnographic examination of the social organization of same-sex sexual practices and structural and psychosocial correlates of sexual risk behavior among Black MSM in four South African township communities. Analysis Qualitative data were coded for purposes of this study in two stages, concept-driven and data-driven coding Gibbs, Table 1 Characteristics of Study Participants Pseudonym. Open in a separate window. First same-sex sexual experiences Participants reported on their first same-sex sexual experiences and how old they were at the time. 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: As Tlotliso goes on to explain, he eventually needed to seek medical intervention: Attributions for Painful Receptive Anal Intercourse Participants were asked about subsequent same-sex sexual experiences i. Partner characteristics The gay-identified men in our sample tended to have more same-sex sexual experience than their bisexual- or straight-identified counterparts. Interpersonal dynamics Participants described other attributions for painful RAI that seemed to arise during the sex act: Sizwe shared the following story about a negative sexual experience: Okay, what was painful about the sex? Was it something that you felt needed to be reported? And did you tell him? Alcohol consumption Participants linked alcohol consumption to painful RAI in several ways. As Dingani explained, in describing how sex differed whether he was sober or drunk: As Tumelo explained, when describing how drinking affected his sexual behavior, the numbing effect of alcohol during a sexual encounter could sometimes have consequences later: 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. Dingani explained how he would communicate his boundaries to his sexual partners: You speak about frozen; which other positions do you negotiate? Kabelo described a similar negotiation process, explaining that he would make assessments about what type of sex to engage in on a case-by-case basis: How big it is…? And most of the time they agree? Yes, they agree. As Kabelo also explained: Have they done it by force to you without lubricant? For example, Mosegi described how what began as a consensual sexual encounter ended in rape when he withdrew consent during an attempt at intercourse that was painful: And so why did he end up beating you up? Lubricant use The majority of participants indicated that they regularly used lubricants during anal intercourse to make penetration easier and reduce pain. As Masopha explained, I would say to gays, the lubricants are the best things since sliced bread. A national school-based survey in South Africa. International Journal for Equity in Health. BMC Public Health. PLoS One. Frequency, patterns, and preferences of lubricant use during anal intercourse within male sexual partnerships in Lima, Peru: Implications for a rectal microbicide HIV prevention intervention. AIDS Care. Anodyspareunia in men who have sex with men: Prevalence, predictors, consequences and the development of DSM diagnostic criteria. Journal of Public Health Policy. Factors associated with self-reported unprotected anal sex among male sex workers in Mombasa, Kenya. Sexually Transmitted Diseases. HIV vulnerability of men who have sex with men in developing countries: Horizons Studies, — Public Health Reports. Analyzing qualitative data. Los Angeles, CA: Sage; Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon. Sexually Transmitted Infections. An exploration into anal sexuality. Sexual and Relationship Therapy. The epidemiology of rape and sexual coercion in South Africa: An overview. Heterosexual anal intercourse among community and clinical settings in Cape Town, South Africa. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. In the dark: The experiences of men who have sex with men with healthcare workers in South African township communities. Alcohol and sexual risk behavior among men who have sex with men in South African township communities. AIDS and Behavior. Social context, sexual risk perceptions and stigma: HIV vulnerability among male sex workers in Mombasa, Kenya. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. Constructions of sexuality among gay men in a low-income South African community. Taverns, bars and shebeens: From social silence to social science: Crying Wife forced in to anal. Mandingo rips open white whores asshole. Monica Sexxxton crams a black huge monster in her ass! Hommade Anal Painful Sex. 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Dingani explained how he would communicate his boundaries to his sexual partners:. When you are having sex do you negotiate what type of sex you want and do you also give the other person a chance to voice what he wants?

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