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anal vs vaginal

Jan 7, 2002

Unprotected anal sex and unprotected vaginal sex are both considered high risk, but is one higher then the other? Ive read that only 7 of cases for men come from heterosexual contact. How can this be when over 95 of people are heterosexual?

Response from Mr. Kull

It is best to use condoms for anal and vaginal sex if your partner is HIV positive or of unknown status. The receptive partner in anal and vaginal sex (the person being penetrated, fucked) is generally considered at greater risk for infection than the insertive partner. It is more likely that there is greater mucous membrane exposure to infected fluids in the receptive partners rectum or vagina. The rectum is susceptible to trauma (tearing and bleeding) during anal sex, which could increase the risk for both insertive and receptive partners.

In the United States, the highest rates of sexual transmission of HIV occur among men who have sex with men (anal sex). The number of men who have been infected through heterosexual contact is MUCH HIGHER than 7. The CDC has documented 29,460 cumulative cases of males with AIDS who had been infected through heterosexual contact; female AIDS cases is practically double at 52,520. HIV disease in the U.S. disproportionately affects people of color, especially gay men and women.

The reasons for different distributions of HIV around the world are complex. The lack of prevention, treatment, health care (higher rates of STDs are greatly associated with heterosexual transmission in Africa) and education in areas of high incidence and prevalence, like sub-Saharan Africa, continues to fan the flames of the epidemic.


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