Data Analysis The audio files produced by the recording equipment in MP3 format were transcribed verbatim and imported into Dedoose, an on-line qualitative analysis program that facilitates coding, sorting, and displaying mixed method data. When these omissions were left out of the calculations, kappa increased to. Informed consent was a two-stage process: Mackesy-Amiti et al. Participants were allowed to respond spontaneously to each question and were not required to seek permission to speak or speak in a designated order. Dedoose was used to assess inter-rater reliability utilizing a random selection of one-third of the excerpts created by the second author. Harawa and Adimora linked high incarceration rates among both men and women in the African American community with HIV through a number of mechanisms, including the role incarceration plays in reducing the number of male sexual partners available to African American women. Results The primary goal of the current study was to uncover a wide range of reasons as to why heterosexual, drug-abusing women engage in anal intercourse. All omissions and discrepancies were then discussed by the coders, and a consensus approach was used to assign final codes. Many of the women also endorsed positive emotional experiences of AI, including that it was more intimate than vaginal sex, and that it was something they reserved only for special partners. The focus groups were constituted so that all the women in each group were of the same ethnicity; group 1 was African American, group 2 was Latina, and group 3 was White, but group 4 was mixed with approximately equal proportions of African American and White women. Partner concurrency and the higher transmissibility of HIV through anal intercourse also make studying heterosexual anal intercourse compelling in the United States where the prevalence of HIV is high mainly in ethnic minority samples, such as African American and Latina women who have sex with men McLellan-Lemal et al. The second stage consent process required the women to give separate consent to have the focus group digitally recorded for later transcription and coding. While this growing body of literature suggests that anal intercourse among heterosexual women may be more prevalent than previously assumed particularly among drug-abusing samples of women , there is currently very little information about why these women are engaging in anal intercourse. Following the recommendations of Krueger , the focus group protocol consisted of five generally worded questions about heterosexual anal intercourse with male partners, how often it had occurred in their lifetime, the frequency of anal intercourse with their current or most recent sexual partner, the context in which the anal intercourse event took place type of partner, such as new, casual, and regular , the role of alcohol and illicit substances in facilitating the anal intercourse, and other relevant characteristics of the male partners known to be bisexual, previous incarceration history and any other information the women were willing to provide concerning the anal intercourse event itself e. All groups were digitally recorded for transcription; transcripts were analyzed using the methods of grounded theory to determine themes.