Sex Talk

I want to try anal sex. How safe is it?

Dr Tlaleng Mofokeng answers your sex questions

14 October 2018 - 00:00
Anal sex carries the most risk of all sexual activity.
Anal sex carries the most risk of all sexual activity.
Image: 123RF/Vadimgozhda

Q. Is anal sex safe?

A. People are becoming more comfortable to discuss their inquisitiveness about anal play and many more are engaging on some level with anal exploration and play.

Anal sex carries the most risk of all sexual activity for several reasons. The anal mucosal lining lacks the glands that produce natural lubrication, the lubrication cannot be compared to what the vagina has.

Anal exposure to HIV is the riskiest for the receptive partner. However, all people who engage in anal sex remain at higher risk than vaginal exposure

Penetration of the anus can cause the tissue to tear, both of the sphincter and on the inside of the anus. This break in the integrity of the mucosa leads to an increase in the transmission of sexually transmitted infections; commonly bacteria and viruses enter the bloodstream.

Anal exposure to HIV, for example, is the riskiest for the receptive partner. However, all people who engage in anal sex remain at higher risk than vaginal exposure. Exposure to syphillis, human papillomavirus (HPV), E.coli and hepatitis are also possible. The bacteria that is normally in the anus can potentially infect the penetrating partner.

Having vaginal sex after anal sex without a condom or without a condom change can also lead to vaginal and urinary tract infections. 

DIGITAL-ANAL CONTACT

Oral and digital contact with the anus can put both partners at risk for STIs, this includes the use of shared penetrative and non-penetrative sex toys. If ejaculation occurs near the vagina, pregnancy can result.

It is always important to use a condom and dental dams to protect against STIs and finger cots can be used for digital-vaginal or digital-anal contact. The condom previously known as the female condom is now called the "single-use internal condom" and the US Food and Drug Administration has approved its use for both vaginal and anal use.

The de-gendered name and expanded indications for this device will better reflect the full spectrum of users and uses of the internal condom. Use a water-based lubricant liberally and add more as required.

People who are HIV-negative and at very high risk for HIV acquisition can take the pre-exposure prophylaxis daily medicine to decrease the risk of HIV. Always consult your health provider for a detailed sexual history and individualised medical advice.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, Disa Clinic, safersex.co.za.

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