Safer sex

How risky is barebacking?

In the gay community, unprotected anal intercourse between men is often referred to as barebacking. This is an extreme high-risk sexual behavior and it is safe only when both partners are not infected with HIV or other sexually transmitted infections. Otherwise, barebacking puts both partners at high risk for infection (or re-infection) from HIV and other STIs.

Body fluids that can transmit HIV and sexually transmitted infections include pre-ejaculatory fluid ("pre-cum"), semen, and blood. The person receiving the semen (referred to as the receptive partner or the "bottom") 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.

Regardless of whether the person engaging in anal intercourse is the ?top? (or insertive partner) or the ?bottom? (or receptive partner), barebacking carries a high risk of spreading HIV. This is, of course, unless both partners are free from HIV or other sexually transmitted infections. Although there are fewer cases of HIV infrection among "top" partners, the incidence of infection is nevertheless significant.

That it is safer on top is a myth. It has:

• given some people a false sense of security
• made it harder for bottom partners to insist on condom use
• led to more cases of HIV infection

The "top" partner may be exposed to HIV through:

• small—even invisible—cuts or tears on his penis
• ulcers or open sores on his penis
• the thin lining inside the urethra

It is also untrue that barebacking is less risky for the ?bottom? partner if the "top" pulls out before ejaculating. Barebacking carries a high risk even if the "top" pulls out before ejaculating ("cumming") because pre-ejaculatory fluid ("pre-cum") can enter the rectum before the "top" pulls out. Barebacking is safe only if both partners are free of HIV or other sexually transmitted infections.

Through the proper use of condoms, anal sex is a low risk activity-for both top and bottom partners. The risk of transmission is even lower if the top partner uses a condom and pulls out before ejaculation.

Regardless of whether you were the "top" or the "bottom", if you have had bareback sex, consider getting tested for HIV and other sexually transmitted infections so you can protect your health and that of your partner(s).