1. In July 2014, The British Medical Journal published Dr Cicely Marston's academic paper 'Anal Heterosex Among Young People And Implications For Health Promotion: A Qualitative Study In The UK'.
2. Marston, who is based at the Faculty of Public Health and Policy, at the London School of Hygiene & Tropical Medicine, carried out the longitudinal qualitative study to explore the expectations, experiences and circumstances of anal sex among 130 young men and women aged 16-18 from diverse social backgrounds.
3. Cath Mercer's research for the 2013 National Surveys of Sexual Attitudes and Lifestyles Survey had already established that almost one in five 16-24 year olds, (19% of men and 17% of women) reported having had anal intercourse in the past year.
4. Since it's publication, 'Anal Heterosex Among Young People And Implications For Health Promotion: A Qualitative Study In The UK' has been cited in ten other academic papers, which is pretty good going for a study that is just over a year old.
5. Unlike most academic papers, Marston's paper is available on 'open access', which means that anyone can read it without having to pay for it. Although it is a very interesting study, its not exactly a fun read, and yet, surprisingly, 'Anal Heterosex Among Young People And Implications For Health Promotion: A Qualitative Study In The UK', has been downloaded an astonishing 45,000 times. If it were a book, these figures would shoot it to the top of all the best-seller lists.
6. Why has a dry (no offence Dr Marston) academic paper, on a not so common sexual practice, caused such a stir? Dr Marston answers that question in her own paper when she explains that "anal intercourse between men and women although commonly depicted in sexually explicit media, is usually absent from mainstream sexuality education and seems unmentionable in many social contexts."
7. And there you have it. In a bid to learn more about a sexual practice which induces a radio silence in all contexts other than pornography, young people have resorted to downloading an academic paper from the British Medical Journal.
8. One can only hope that the 45,000 people who downloaded the paper understood the dire significance of Marston's findings. The young men and women in her study routinely normalised painful and unsafe anal heterosex. Coercion seemed to be taken for granted and the expectation amongst young men was that women would find anal sex painful and that they would therefore have to be persuaded to do it.
9. Although interviewees frequently cited pornography as the 'explanation' for anal sex, peer pressure seemed to be more of a problem. Many young men said they encouraged one another to try the practice and both genders agreed that young men did it because they wanted to tell their friends about it. In a group discussion, young men admitted that anal sex was "something we do for a competition", because "every hole's a goal."
10. Marston concludes that there is an "urgent need for harm reduction efforts targeting anal sex to help encourage discussion about mutuality and consent, to reduce risky and painful techniques and to challenge views that normalise coercion". In a country where sex education is not statutory and sexual health services are being ruthlessly hacked? Don't hold your breath Dr. Marston.