TeenHealthFX - Answers - Safe Anal Sex

Oral & Anal Sex / Question
Published: August 23, 2006

Dear TeenHealthFX,

Hi, I’ve recently started having anal sex with my boyfriend (with condom and lube). I had blood on the toilet tissue last time I went. I don’t think it’s from inside my bowel but a small tear in my sphincter. Can I get aids from this? And do I need to go see a doctor urgently? Also how can I have safe anal sex in the future?

Signed: Safe Anal Sex

Dear Safe Anal Sex,

Since your question raises two important topics, the transmission of HIV/AIDS and safer anal sex practices, FX will cover both topics one at a time.

AIDS, which is short for the Acquired Immune Deficiency Syndrome, is the most advanced stage of the HIV disease. HIV disease is cause by HIV – the human immunodeficiency virus. It is important to be educated about HIV/AIDS, including methods of transmission, as approximately 40,000 men and women are diagnosed with HIV in the USA each year.

HIV is transmitted in blood, semen, vaginal fluids and breast milk. The most common ways HIV is spread include:

Unprotected sexual intercourse with someone who is infected with the virus.
Sharing needles or syringes with someone who has the virus.
Being deeply punctured with a needle or surgical instrument that is infected with the virus.
Getting HIV-infected blood, semen, and vaginal secretions into open wounds or sores.
HIV can also be passed on from a woman to her fetus during pregnancy, childbirth or breastfeeding. Keep in mind that there are methods of preventing the virus being spread from mother to child, which can be discussed with a physician.
Keep in mind that HIV can NOT be spread by simple casual contact such as kissing, sharing glasses or hugging.

The best way to prevent becoming infected with HIV is to abstain from sexual intercourse and from sharing needles if you use steroids, hormones or other drugs.

1. If you choose to have sexual intercourse:

Consider your partner’s HIV status. Does your partner have any other partners? Does your partner share needles?
Have safer sex to reduce the risk of exchanging blood, semen or vaginal fluids with your sex partner.

2. If you choose to use needles:

Do not share your needles
Go to a needle exchange program
Be sure to disinfect the needles you use.

3. Do not share personal items that might be soiled with blood, such as toothbrushes, razors, needles for piercing or tattooing, and blades for cutting or scaring.

4. Talk with your doctor about testing for STDs. Women and men with open sores from Herpes and other infections get HIV more easily than other people.

5. Stay in charge. Good judgment and self control are the basis of safer, healthier sex. Alcohol and drugs weaken both. Do not risk your good judgment and self control with alcohol and drugs.

Here are some common sexual behaviors grouped according to relative risk:

Very Low Risk – No reported cases due to these behaviors:

Phone sex
Using clean sex toys
Mutual masturbation
Massage or erotic massage
Kissing
Oral sex on a man with a condom
Oral sex on a woman with a dental dam or plastic wrap

Low Risk – Rare reported cases due to these behaviors:

Vaginal intercourse with a condom or female condom
Anal intercourse with a condom or female condom

(Try not to get blood, semen or vaginal secretions into the mouth or on broken skin)

Oral Sex

High Risk – Millions of reported cases due to these behaviors:

Vaginal intercourse without a condom
Anal intercourse without a condom

If you are worried that you may have contracted HIV, you can get tested through most physicians, hospitals and health clinics, including Planned Parenthood. Local, state and federal health departments offer free testing. Some have anonymous testing and counseling sites. You can also buy an anonymous home testing kit at a drugstore or at www.homeaccess.com . Some testing sites now offer rapid testing that can provide results in less than an hour.

To answer your specific questions, if your partner has HIV or AIDS, and his blood or semen came into contact with an open sore on you, it is possible for you to be infected. If you have any concerns that you might have contracted HIV, FX suggests that you get tested as soon as possible and refrain from sexual activity, particularly with any other partners, until you do so. If you are unsure of your partner’s HIV/AIDS status, FX also recommends that he be tested as well.

In answer to the second part of your question, it is possible to practice safer anal sex as long as you are aware of necessary precautions you need to take. Your anus and rectum do not have their own natural lubrication or the elasticity that is found with the mouth and vagina. That is why anal sex must be practiced with care and why three things are needed to practice safer anal sex: lubrication, condoms and common sense.

Lubrication: Liberal amounts of lubrication are necessary because the rectal wall can be quite sticky and is subject to tearing and lesions if not kept lubricated. In addition, the anus and rectum are narrow, so a water-based lubricant is needed to press inside smoothly.
Condoms: Enemas, douches and other cleaners will not be able to get all the germs and bacteria out of the rectum. Not only can anal sex facilitate the transmission of STDs more than any other form of sex, it can also cause urinary tract infections and other bacterial diseases. Latex protection is therefore essential to protect against both bacterial diseases and STDs, and can offer additional slickness.
Common Sense: Because the rectal wall curves and is thin, long and hard objects can easily tear your insides. Do not wear any jewelry on your hands and do not maintain long nails if you plan on putting your fingers in someone’s anus. Also avoid penetration with fingers or a fist if there are abrasions or cuts on the hands or arm – and wear a latex glove and used a water-based lubricant to be safe. And do not share penetrative sex toys such as dildos – consider having separate collections, covering them with a new condom each time they are used, or washing them thoroughly with warm, soapy water between partners. Overall, respect your body – do not push the limits and go only as far as you feel comfortable with any type of sexual activity.

If you don't have a doctor and live in northern New Jersey, you can call the Adolescent/Young Adult Center for Health at 973-971-6475 for an appointment or contact your local teen health center or Planned Parenthood. You can also contact Girl’s Street – A Young Woman’s Health Program – at 908.522.2555.

You can also contact the National AIDS Hotline at 1-800-342-2437, 24 hours, 7days a week, for more information.

Signed: TeenHealthFX