HIV and other STIs in anal intercourse
Page last reviewed 5.4.2024
The highest risk of HIV is in anal intercourse without a condom and lubricant. The risk of HIV transmission is higher for the bottom. If you have had anal intercourse without a condom, chlamydia and gonorrhea samples must also be taken from the anus.
Unprotected anal intercourse increases the risk of HIV transmission. In anal intercourse without a condom, bottom can get the HI-virus from their sex partner into their bloodstream through the mucous membranes of the rectum. During unprotected anal intercourse, the top can get HI-virus through the mucous membranes located on the glans, tip of the urethra and on the inner surface of the foreskin in the penis.
Other STIs such as chlamydia, gonorrhea, syphilis, hepatitis B or C can be transmitted in anal intercourse without a condom. When taking STI tests, a chlamydia and gonorrhea sample must also be taken from the anus, if you have been the recipient of anal intercourse and a condom has not been used.
A condom effectively protects against HIV and other STIs when it is used with a lubricant throughout intercourse. Condoms come in different sizes and models, and only by trying you will find the one that suits you. The lubricant should be water-soluble or silicone-based, as oil-based lubricants make the condom brittle. The use of saliva as a lubricant during anal intercourse is not recommended because, according to preliminary studies, there is a risk of gonorrhea infection. Read more about condoms and lubricants here.
PrEP medication effectively protects against HIV transmission during anal intercourse. You can get more information about PrEP medication here. If a person living with HIV is on effective medication, HIV cannot be transmitted through anal intercourse, even without a condom. You can find more information about HIV infection here.
You can read more about anal sex, for example preparation for it and different positions, in our brochure The ABC for anal sex.