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,


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Find an ACG member gastroenterologist with a specialized interest in liver disease. The rectum refers to the last four or five inches of the digestive tract. The rectal outlet or opening is called the anal canal or anus.



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