Canadian Health Network

How risky is anal sex?

Very! Unprotected anal intercourse (inserting the penis into the rectum) is a main risk factor for HIV infection. It is also connected to the spread of other infections, including hepatitis, genital warts, chlamydia and gonorrhea.

The person receiving the semen is at greater risk of getting HIV because the linings of the anus and rectum are thin (thinner than the lining of the vagina) and tiny tears can allow the virus to enter the blood stream during sex.

So anal sex isn’t only for gay men?

No. Many people assume that only gay men have anal sex, but the reality is that many more heterosexual people have anal sex than do gay men. In the gay community, unprotected anal sex is sometimes referred to as “barebacking” (see Question “How risky is barebacking?”).

Many young people, particularly young women, believe that by having anal (instead of vaginal) intercourse they are protecting their virginity. Anal sex is sometimes called “virgin sex” by young people. Since some people believe that anal sex “doesn’t count” as sex because it does not lead to pregnancy, they also don't consider the need for disease prevention.

There are many definitions of “sex” and “virginity.” Individuals need to decide for themselves how they define sexual activity and virginity. But, no matter how you define it, unprotected anal intercourse is a high-risk behaviour for HIV infection.

How can I make anal sex safer?

There are a number of things you can do to reduce the risk of HIV infection during anal sex:

• Use condoms. With proper condom use, anal intercourse is a low risk activity.
• Use lubrication. Water-based lubricant will reduce the risk of condom breakage and will reduce the risk of tears or rips of the anus.
• Try other anal sex activities that are less risky, including anilingus (anal stimulation with mouth/tongue), manual-anal penetration (anal intercourse using the hands), or use clean or unshared sex toys.

What if I have had unprotected anal sex?

• Consider getting tested for HIV and other sexually transmitted infections (STIs) so you can protect your health and avoid transmitting infection to your partner(s) (see Questions “Should I get tested for HIV?” and “How do I get tested?”).
• Talk to your partner(s) about safer sex and discuss the possibility of exploring other, less risky activities (see Questions “How can I have sex more safely?” and “How do I talk about using condoms?”).

For more information, contact your local AIDS service organization or health care practitioner.