There is a lot of misinformation surrounding the question of whether or not you can get STDs from anal sex. On the one hand, there are many people who don’t consider anal sex to be a form of sexual intercourse, and in that instance, they might not link the practice with the risk of contracting or transmitting STDs or STIs like they do with vaginal sex. On the other hand, anal sex has been associated specifically with the transmission of HIV, so there are popular notions that relate to HIV being the only STD or STI you can get from anal sex.
However, both of these assumptions are myths. Anal sex is a sexual act like any other in that it’s possible to contract or transmit an STD or STI through the act.
While it’s possible to contract or transmit several STDs through anal sex, HIV is perhaps the most well known STD that can be transmitted through anal sex. This is primarily due to the infection’s association with gay men, though anyone can transmit or contract HIV by having anal sex, or other kinds of sex, with someone who is HIV positive.
Of the sexual acts in which HIV can be transmitted, anal sex is considered to be the highest risk, followed by vaginal sex and then oral sex. The risk associated with contracting HIV through anal sex differs depending on which partner is infected with HIV. Insertive partners (the partner inserting their penis) are at a lower risk of contracting HIV through anal sex than receptive partners (the partner receiving the penis). Being a receptive partner and having sex with an insertive partner who is HIV positive is up to 13 times more likely to result in the transmission of the virus when compared to sex involving an HIV positive receptive partner and HIV negative insertive partner. The reason the receptive partner’s risk is so much higher is that the lining of the rectum is thin and prone to microtears, which can allow fluids carrying the virus to easily enter the body. Regular HIV testing should be practiced for both parties when this type of contact occurs.
It’s important to note, however, that HIV transmission can still occur in either case. No matter which partner is infected, it’s possible for HIV transmission to occur whenever bodily fluids, including blood, semen, pre-cum or rectal fluids, from someone who is infected come into contact with an uninfected partner. Though receptive partners are at a higher risk, an insertive partner could still contract the virus through the opening at the tip of the penis or through small cuts, scratches or open sores on the penis.
HIV isn’t the only STD that can be passed through anal sex. Chlamydia, gonorrhea and syphilis, as well as hepatitis B and C, can be transmitted to the rectum if you have anal sex with someone who is infected.
Similarly to the case with HIV, anal sex can sometimes put you at a higher rate of contracting one of these STDs from an infected partner, for the same reasons that receptive partners are at higher risk of contracting HIV.
Any STD or STI that can be transmitted through skin-to-skin contact, such as herpes or HPV, can also be transmitted to the inside or outside of the anus and rectum, spreading as far as the buttocks in some cases. All it takes for transmission to occur is for the skin in these areas to come in contact with a sore.
Symptoms associated with STD transmission in this region include rectal burning, unusual discharge, bleeding, pain, or fissures. You might also develop symptoms elsewhere, such as blisters or achiness in the groin.
Reducing the risk of contracting STDs from anal sex
Like with other sexual acts, the use of condoms will help prevent the transmission of STDs from one partner to another.
If you’re specifically concerned about contracting HIV, antiviral medications referred to as PrEP and PEP (pre-exposure prophylaxis and post-exposure prophylaxis, respectively) can reduce both partner’s chances of HIV transmission. PrEP is for people who are HIV negative, and PEP is for people who are HIV positive. Regular daily use of these medications as prescribed can significantly reduce the risk of HIV transmission.