Anal sex has a higher risk of passing on STIs than other types of sexual activity. But it can be safe if you plan well, communicate clearly and take some simple steps to reduce the risks. 

Our advice applies to all kinds of anal sex. This includes oral sex, known as rimming, and penetration with a penis, fingers, fist or sex toy.

What are the risks?

Inside the bottom the lining of the anal canal is thin, and it does not have any natural lubrication. This means it can easily be damaged. Damage to the anal canal makes it easier to pass on STIs, including HIV, during anal penetration.

You also need to be careful to avoid infections that spread through poo, as these can also be spread through anal sex. This includes shigella and hepatitis A.

Having cuts or sores anywhere on your mouth, fingers, genitals or anus can increase your chance of passing on or getting these infections.

If you regularly have unprotected anal sex with new partners then consider taking pre-exposure prophylaxis (PrEP). These are drugs that reduce your risk of catching HIV. Find out more about PrEP.

Safe anal sex

Here are simple steps you can take to reduce your risks.

  • use barrier methods to reduce direct contact during anal sex, for example, cover penises and sex toys with an external, male, condom. Use a dental dam during oral sex and rimming. Use latex gloves when fingering or fisting.

  • make sure to remove and replace any barrier, whether it's a glove on your hand or a condom on a toy when you move your play from anal to mouth or vagina. If you do not use a fresh barrier, you can spread infections between these body parts. 

  • use a water-based lubricant during anal penetration. Lube can increase pleasure as well as prevent damage to the anal canal. It can also help stop condoms from breaking.

  • wash your hands and have a shower after anal sex. And before you begin any other kind of sex

  • do not share sex toys or other equipment, for example, douching equipment.

If anal activity is a regular part of your sex life, we recommend:

  • speaking to your sexual health clinic to find out if you can get any vaccinations.  Vaccines that protect against HPV, hepatitis B and hepatitis A might be available.

  • regularly testing for STIs. Find out more about when you should test.

  • planning ahead. Read about post-exposure prophylaxis (PEP) and where you can get it, in case you ever think you've been exposed to HIV. PEP is effective if taken within 72 hours of exposure.

  • consider pre-exposure prophylaxis (PrEP) if you’re regularly having unprotected anal sex. These are drugs that reduce your risk of catching HIV.


Reviewed by Dr Paula Baraitser. Medical Director, SH:24
Last updated at: 02 February 2024
Published on: 12 August 2022