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Prevalence, predictors, consequences and the development of DSM diagnostic criteria. 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. In a relaxed state, the average vagina is about 7. Participants were asked about subsequent same-sex sexual experiences i. 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. HIV vulnerability of men who have sex with men in developing countries: The epidemiology of rape and sexual coercion in South Africa:

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We also thank study staff at all participating institutions for their work and dedication.

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Yet the fact that many participants in this study recognized their same-sex attractions well before engaging in any same-sex sexual behavior suggests that there is an opportunity to deliver the relevant information before men first engage in anal intercourse. 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. Sizwe shared the following story about a negative sexual experience: A few interviews were conducted completely in Tswana or Northern Sotho. Frequency, patterns, and preferences of lubricant use during anal intercourse within male sexual partnerships in Lima, Peru:

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