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Anal insertive intercourse is safe?

Aug 12, 1996

Can I get HIV if I engage in anal intercourse with an infected person, and I am the insertive partner using no condom (with no wounds or sore spots in my penis)but just lubricant with nonoxynol-9?If I ejaculate inside my partner's rectum, does this increase the risk TO ME?I understand the risks of anal intercourse being the receptive partner, but not for the insertive partner. Please explain.

Response from Mr. Sowadsky

Hi. Thank you for your question.

If you are the insertive partner for anal intercourse (the "top"), you are at high risk of infection with HIV and other Sexually Transmitted Diseases (STD's).

Normally, during anal intercourse, the insertive partner is being exposed to their partners blood, which contains high concentrations of the HIV virus. During intercourse, due to the friction that normally occurs, there are usually microscopic cuts/abrasions that are found on the head of the penis where HIV can enter into your bloodstream. These openings are too small for you to see, but large enough for HIV to get into your body. In addition, if you have another STD where there are open lesions (like herpes and syphilis, and others as well), HIV can enter into these openings and get into your body.

When we're looking at anal intercourse, the insertive partner (the "top") is at high risk for HIV and other STD's, and the receptive partner (the "bottom") is at even higher risk. Unprotected anal intercourse is therefore risky for both partners.

Whether you ejaculate or not will not affect your risk of infection. But if you are already infected, if you ejaculate inside your partner, it will increase their risk of infection, since semen has a lot of the virus in it. Therefore if you ejaculate in them, it will significantly increase their risk for this and other diseases.

Nonoxynol-9 by itself will NOT adequately protect you against HIV and other STD's. It MUST be used along with a condom. If you have been having unprotected anal sex with anyone, you might want to seriously consider getting tested for HIV and other STD's.

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