What should I know about anal sex and HIV risk?

Anal intercourse – when one partner inserts their penis (or a finger or sex toy) into the other partner’s anus – is a highly risky activity for transmission of HIV (the virus that causes AIDS) as well as other sexually-transmitted infections (STIs).

Anal sex partners are usually described as tops (the person inserts his penis into the anus) and bottoms (the person who receives the penis in the anus).

According to the U.S. Centers for Disease Control and Prevention (CDC), bottom partners are 13 times more likely to become infected with HIV than top partners.

Why is anal sex so risky? 

During anal sex, partners can come into contact with body fluids like blood, semen, pre-seminal fluid, and rectal fluid. These fluids can contain HIV.

Viruses and bacteria can enter the top partner’s body through cuts and sores on the penis or a finger. Sometimes, these cuts are so small, you don’t even know they are there.

The anatomy of the anus makes transmission riskier for the bottom partner. The lining of the anus is thin and does not lubricate like the vagina does. As a result, it can tear, making it easier for viruses and bacteria to enter.

Other STIs, including gonorrhea and chlamydia, can be spread through anal sex as well.

 

Talking to a doctor 

Unfortunately, not all people tell their doctors that they have anal sex. For many, anal sex is taboo and participants are reluctant to discuss it at all. Some feel embarrassed or ashamed.

In a 2020 Journal of Sexual Medicine study of 1,263 men who have sex with men, researchers found that stigma often prevented participants from discussing their anal sex practices with their doctors. By staying silent, patients may not get access to safe sex advice and healthcare services that could lower their risk for HIV transmission.

The study authors encouraged healthcare providers to help patients become more comfortable with the topic of anal sex.

 

Safe anal sex 

People who have anal sex should make sure they do so safely:

Note: These drugs might decrease HIV risk, but they do not protect against other types of STIs.

Resources

Centers for Disease Control and Prevention 

“Anal Sex and HIV Risk”

(Page last reviewed: November 8, 2019)

https://www.cdc.gov/hiv/risk/analsex.html

International Society for Sexual Medicine

“Is anal sex common? Is it dangerous?”

https://www.issm.info/sexual-health-qa/is-anal-sex-common-is-it-dangerous/

The Journal of Sexual Medicine 

Kutner, Bryan A., PhD, MPH, et al.

“Does Stigma Toward Anal Sexuality Impede HIV Prevention Among Men Who Have Sex With Men in the United States? A Structural Equation Modeling Assessment”

(Full-text. Published online: January 13, 2020)

https://www.jsm.jsexmed.org/article/S1743-6095(19)31865-X/fulltext

Medical News Today 

Nall, Rachel, RN, MSN, CRNA

“What are the risks of anal sex?”

(March 6, 2019)

https://www.medicalnewstoday.com/articles/324637

You Might Also Enjoy...

Understanding Male Menopause

Menopause is a process that every woman experiences with age, but did you know hormonal imbalance (and its symptoms) aren’t just a women’s health issue? Male menopause is triggered by low testosterone, and it can impact your life in a number of ways.

How the O-Shot® Can Improve Your Sex Life

Low sex drive. Painful intercourse. Inability to orgasm. Sound familiar? You could be suffering from sexual dysfunction. It’s a real condition, and it’s treatable. Find out how the O-Shot® — a platelet-rich plasma therapy — could help you.

My Hormones Are Out of Balance

Hormones are important chemical messengers in your body. When they’re out of balance, you could experience a range of unpleasant symptoms. Learn the signs of hormone imbalance and what you can do to relieve your symptoms.

Help! I'm Struggling With Low Libido

Low libido can make you feel embarrassed, frustrated, and angry. It’s a common problem, but you don’t have to accept it. Learn more about sexual dysfunction, what causes it, and how you can treat it to revitalize your sex life.

Can Any Medicine Help With Peyronie's Disease?

If you have Peyronie’s disease, you’re likely all too familiar with the curved, painful erections it causes. Peyronie’s disease can hinder your self-esteem and your sex life, but it’s treatable. Find out if prescription XIAFLEX® is right for you.

Are You Suffering From Vaginismus?

Vaginismus commonly makes vaginal penetration painful or impossible. If you can’t have penetrative sex, use tampons, or get pelvic exams, you could be suffering from vaginismus. Learn more about it and find treatment here.