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Anal sex

Having anal sex without a condom is one of the highest-risk activities in terms of transmission of HIV (and other sexually transmitted infections). Being on HIV treatment with an undetectable viral load or correctly using condoms each time you have sex can prevent HIV transmission.

The chances of a man passing on HIV during anal sex is greatest when he is the active, or insertive, partner during sex. The risk is particularly high if you have a high viral load, if you have an untreated sexually transmitted infection (as these can cause inflammation or damage to tissue in the genital area), if you ejaculate inside your partner, or if you have sex that causes tissue damage.

Using poppers (a recreational drug) during sex significantly increases the chance of the receptive partner acquiring HIV (these seem to increase blood flow to tissue in the rectum).

Similarly, if an HIV-negative person has an untreated sexually transmitted infection, their chances of contracting HIV during sex without a condom are increased.

If you are the receptive, or passive, partner during sex, the risk that you will pass on HIV is reduced, but there is still a risk – especially if you have a high viral load or an untreated sexually transmitted infection.

HIV & sex

Published January 2016

Last reviewed January 2016

Next review January 2019

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap