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Is anal sex safe?

Anal sex can describe any type of sexual activity that involves the anus (the opening to a person’s back passage). This includes oral sex (also called rimming) or penetrative sex, such as the insertion of a penis, one or more finger(s) or sex toys.

Anal sex can be safe if planned well, precautions are taken and everyone involved is aware of and communicates their needs and wishes.

There are some specific risks of infection related to anal sex: The lining of the anal canal is thin, does not produce natural lubrication like the vagina and is therefore easily damaged. This means that it can be easier to pass on infections during penetrative anal sex, including normal STIs those that are present in the blood, such as HIV. As the anus is also where faeces (poo) passes out from, any sexual activity involving this area can increase the likelihood of getting or passing on other infections that are transmitted through faeces. This includes shigella and hepatitis A.

As with all sexually transmitted infections, the likelihood of passing on or getting these infections increases if any body parts (mouths, fingers, genitals, anus) have cuts or sores.

Steps can be taken to reduce the chances of getting or passing on infections during anal sex. These include:

  • Using barrier methods to reduce direct contact during anal sex, for example:

  • using a ‘male’ condom for the penis and sex toys

  • using a dam (a thin film of material to go in the mouth) during oral sex

  • changing condoms between anal and oral or vaginal sex

  • using gloves when fingering or fisting

  • Using a water-based lubricant during penetrative anal sex, alongside a condom, to reduce the risk of breakage

  • Washing hands thoroughly and showering after anal sex and before engaging in other types of sex

  • Not sharing sex toys or other equipment, e.g. douching equipment

There are vaccinations available for some - but certainly not all - infectious diseases that can be spread through anal sex, such as HPV, Hepatitis B and Hepatitis A. Speak to a clinician in your sexual health clinic about what you might be eligible for.

It is also important to get tested regularly for STIs.

If someone thinks they have been exposed to HIV, they may be eligible (depending on the risk assessment) for post-exposure prophylaxis for HIV if they present within 72 hours after sexual exposure.

References:

  1. https://www.nhs.uk/live-well/sexual-health/sex-activities-and-risk/
  2. https://www.fsrh.org/standards-and-guidance/documents/ceuguidancebarriermethodscontraceptionsdi/
  3. https://www.nhs.uk/common-health-questions/sexual-health/does-anal-sex-have-any-health-risks/

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Dr Gillian Holdsworth headshot

This post was clinically reviewed by:
Dr Gillian Holdsworth Fettle's Managing Director, Medical Doctor and public health expert.

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