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Anal sex

Unprotected (i.e. without a condom) anal sex is one of the highest-risk means of passing on HIV.

The chances of a man passing on HIV during unprotected 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 during sex significantly increases the chance of the receptive partner becoming infected (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 from you during unprotected sex 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 February 2011

Last reviewed February 2011

Next review February 2014

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 It may have been superseded by more recent developments.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.