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In-depth interviews were conducted with 81 Black MSM ages 20—39 years who were purposively recruited from four townships. The semi-structured Huge cock anal penetration 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 Huge cock anal penetration 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.

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In a sample of primarily white, gay-identified men in the U. Such symptoms could result from or precede incidents of painful RAI.

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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 Huge cock anal penetration 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.

Huge cock anal penetration 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 Huge cock anal penetration 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 Huge cock anal penetration 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.

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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.

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The Project Manager conducted an initial phone screening with each interested candidate, to ensure that he met the study eligibility criteria and to inform the purposive selection of individuals for interviews.

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; Huge cock anal penetration 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.

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Qualitative data were coded for purposes of this Huge cock anal penetration 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 Huge cock anal penetration 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.


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