Condom use in anal intercourse amongst people who identify as homosexual, heterosexual or bisexual.

AIMS: to study condom use amongst those who practice anal intercourse.

METHODS: a sample of 814 clients attending anonymously for pretest counselling for HIV infection at the Burnett Clinic, Auckland, gave detailed information about their sexual behaviour.

RESULTS: insertive or receptive anal intercourse was reported in 39% of clients. This included 89% among homosexual men, 78% among bisexual men, 17% among heterosexual men and 21% among heterosexual women. In those practising anal intercourse concomitant condom use was reported by 71% of homosexual men, 53% of bisexual men, 16% of heterosexual men and 7% of heterosexual women. Those most likely to use condoms were homosexual men, prostitutes, those with multiple partners and those with an HIV infected partner. Those least likely to use condoms were heterosexual men or women.

CONCLUSIONS: whilst substantial changes in sexual practices appear to have been made in the homosexual community, heterosexuals practising anal intercourse have made few such changes. More explicit AIDS education may be necessary which acknowledges that anal intercourse is practised by heterosexuals and advises condom use accordingly.