Whether you're male or female, being the receptive partner—the "bottom"—during unprotected anal intercourse is linked to a high risk of HIV infection. The reason for this is that HIV-infected semen—and this includes pre-ejaculate (pre-cum)—can come into contact with mucosal tissues in the anus, which are easily damaged during anal intercourse.
Is the insertive partner (the "top") also at risk for contracting HIV during unprotected anal intercourse? While studies haven't proven it, we do know that men can be infected with HIV through vaginal intercourse—an activity in which they are the insertive partner.
To reduce the risk:
- Correctly and consistently use latex or polyurethane condoms every time you have anal intercourse with a partner who is positive or whose HIV status you do not know.
- Use a water-based or silicone-based lubricant with latex condoms. Lube keeps condoms gliding smoothly, reducing the risk of rips and tears. Lubrication also helps protect the paper-thin anal wall from rips and tears, which can increase the risk of transmission.
- Don't douche before engaging in anal intercourse. This can destroy the healthy bacteria in the anus and eliminate natural lubrication.
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