Safer sex

How risky is anal sex?

Although many people assume that only gay men have anal sex (see How risky is barebacking?), the reality is that anal sex is actually more common among heterosexuals than among gay men. Many young people—particularly young women—believe that by having anal intercourse rather than vaginal intercourse, they are protecting their virginity. They may believe anal sex doesn't count as sex because it cannot result in pregnancy. For this reason, some don't believe there is any need to practice safe sex and disease prevention.

Body fluids that can transmit HIV and\ sexually transmitted infections include pre-ejaculatory fluid ("pre-cum"), semen, and blood (including menstrual blood). The person receiving the semen (referred to as the receptive partner) is at higher risk of getting HIV because the linings of the anus and rectum are thin and tiny tears can allow the HIV virus to enter the bloodstream during anal sex.

To reduce the risk of HIV and other sexually transmitted infections during anal sex, use condoms. When used properly, condoms make anal intercourse a low-risk activity. Use of a water-based lubricant reduces the risk of condom breakage and of tears or rips of the anus.

Consider other anal sex activities that carry less of a risk. These include anilingus (anal stimulation with mouth/tongue), manual-anal penetration (anal intercourse using the hands), or use clean or unshared sex toys.

If you've had unprotected anal sex:

• Consider getting tested for HIV and other sexually transmitted infections (STIs). This will help you protect your health and avoid possibly infecting your partner(s).
• Talk to your partner(s) about safer sex and the use of condoms. (Refer to No excuse not to wear a condom for useful tips on talking to your partner.)
• Talk to your partner about the possibility of exploring other, less risky activities including massage, masturbation, kissing, touching, oral sex, fingering, or the use of clean, unshared sex toys.