Fast Facts Anal sex is the riskiest sexual behavior for getting and transmitting HIV for men and women. Even more protection is provided when more than one option is used. Anal sex may also expose individuals to other sexually transmitted diseases or other infections.
The risk of getting HIV varies widely depending on the type of sexual activity. Anal sex intercourse , which involves inserting the penis into the anus, carries the highest risk of transmitting HIV if either partner is HIV-positive. Using more than one of these options at the same time provides even greater protection.
Vaginal sex has a lower risk, and activities like oral sex, touching, and kissing carry little to no risk for getting or transmitting HIV.
The vast majority of men who get HIV get it through anal sex. However, anal sex is also one of the ways women can get HIV. Receptive Versus Insertive Sex During anal sex, the partner inserting the penis is called the insertive partner or top , and the partner receiving the penis is called the receptive partner or bottom. Receptive anal sex is much riskier for getting HIV. The bottom partner is 13 times more likely to get infected than the top.
Using condoms or medicines to protect against transmission can decrease this risk. Being a receptive partner during anal sex is the highest-risk sexual activity for getting HIV. The insertive partner is also at risk for getting HIV during anal sex. Even if a condom is used, some STDs can still be transmitted through skin-to-skin contact like syphilis or herpes.
If one has never had hepatitis A or B, there are vaccines to prevent them. A health care provider can make recommendations about vaccines. Reducing the Risk Condoms and Lubrication Latex or polyurethane male condoms are highly effective in preventing HIV and certain other STDs when used correctly from start to finish for each act of anal sex. Condoms are much less effective when not used consistently. It is also important that sufficient water- or silicone-based lubricant be used during anal sex to prevent condom breakage and tearing of tissue.
PrEP is much less effective when it is not taken consistently. Only condoms can help protect against other STDs. PEP should be used only in emergency situations and must be started within 72 hours after a possible exposure to HIV, but the sooner the better. PEP must be taken once or twice daily for 28 days. To obtain PEP, contact your health care provider, your local or state health department, or go to an emergency room.
ART For those living with HIV, antiretroviral therapy ART can reduce the amount of virus in the blood and body fluids to very low levels, if taken the right way, every day. Only condoms can help protect against some other STDs. Other Ways to Reduce the Risk People who engage in anal sex can make other behavioral choices to lower their risk of getting or transmitting HIV.
Choose less risky behaviors like oral sex, which has little to no risk of transmission. Get tested and treated for other STDs.