Objectives: The objectives of this study were to investigate how young women perceive and experience anal intercourse, and how it fits into their sexual and reproductive health behaviors. Methods: In-depth interviews were conducted with 29 young women ages 18-24 years who reported any lifetime experience of anal intercourse. Interviews lasted no more than 90 minutes and were audio-recorded, transcribed, verified, and coded in ATLAS.ti. Themes related to partnership contexts in which anal sex occurs, reasons for, perspectives on and experiences with anal sex, risk perceptions and risk management related to anal sex versus vaginal sex, contraceptive and condom use, and sources of information about anal sex were explored. Results: With some exceptions, young women described the partnership in which they had anal sex as committed and closed. Many participants interpreted STI/HIV risk from anal sex as less than or equal to STI/HIV risk from vaginal sex. Young women described a dearth of information about anal sex gained via formal avenues, such as school education or healthcare providers, relying more on information accessed through informal channels. Conclusion: Findings suggest that among the women interviewed, anal sex is not a casual behavior. Young women who have engaged in anal sex do not distinguish risks related to anal sex differently than risks related to vaginal sex. This study lends valuable insight about young women’s decision-making around anal intercourse, providing critical information for sexual and reproductive health providers and researchers on the social context surrounding heterosexual anal sex practices.