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Can You Get Hiv From Anal Sex

How Long Can Hiv Survive Outside The Body

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Once outside the body, HIV usually cant survive for very long. Coming into contact with blood or semen that has been outside the body doesnt generally pose a risk for HIV transmission.

Similarly, the risk of passing on HIV to someone else if you have a detectable viral load and cut yourself is also very low. Wash away any blood with soap and hot water and cover the wound with a sticking plaster or dressing.

Putting A Number On It: The Risk From An Exposure To Hiv

This information was provided by CATIE . For more information, contact CATIE at 1-800-263-1638.

Author: James Wilton

Service providers working in HIV prevention are often asked by their patients and clients about the risk of HIV transmission from an exposure to HIV through sex. What do the latest studies tell us about this risk? And how should we interpret and communicate the results?

Strategies To Reduce Risk

As with any other mode of HIV transmission, prevention requires a combination of strategies to more effectively:

  • Reduce the infectivity of the HIV-positive partner
  • Reduce the susceptibility of the HIV-negative partner

Current evidence has shown that the consistent use of antiretroviral therapy in the HIV-infected partner completely eliminates the risk of HIV transmission when viral activity is suppressed to undetectable levels.

The effectiveness of the strategy known as Treatment as Prevention , is evidenced by the PARTNER1 and PARTNER2 studies in which not a single HIV infection occurred among 1,770 gay and heterosexual mixed-status couples despite engaging condomless anal or vaginal sex.

The studies, which ran from 2010 to 2018, showed unequivocally that undetectable equals untransmittable in a real-world setting.

The use of pre-exposure prophylaxis , whereby the uninfected partner is prescribed a daily dose of the HIV drug Truvada, can also reduce risk. Studies have shown that when taken daily, PrEP reduces the risk of getting HIV from sex by about 99%.

Although these figures may suggest that condoms are no longer needed, neither TasP nor PrEP can prevent other sexually transmitted diseases.

Moreover, according to the Centers for Disease Control and Prevention , only 59.8% of Americans with HIV are able to achieve an undetectable viral load. Without complete viral suppression, TasP is rendered useless, placing the uninfected partner at risk.

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All Exposures Are Not Equal

The results of several meta-analyses suggest that some types of sex carry on average a higher risk of HIV transmission than others. Below are estimates from meta-analyses that have combined the results of studies conducted in high-income countries. For types of sex where meta-analysis estimates do not exist, numbers from individual studies are provided.

Anal sex

A meta-analysis exploring the risk of HIV transmission through unprotected anal sex was published in 2010.1 The analysis, based on the results of four studies, estimated the risk through receptive anal sex to be 1.4%. This risk was similar regardless of whether the receptive partner was a man or woman.

No meta-analysis estimates currently exist for insertive anal sex but two individual studies were conducted to calculate this risk. The first, published in 1999, calculated the risk to be 0.06% .2 However, due to the design of the study, this number likely underestimated the risk of HIV transmission. The second study, published in 2010, was better designed and estimated the risk to be 0.11% for circumcised men and 0.62% for uncircumcised men.3

Vaginal sex

A meta-analysis of 10 studies exploring the risk of transmission through vaginal sex was published in 2009.4 It is estimated the risk of HIV transmission through receptive vaginal sex to be 0.08% .

A meta-analysis of three studies exploring the risk from insertive vaginal sex was estimated to be 0.04% .4

Oral sex

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Playing the HIV numbers game is lessand morerisky than you think.

EDITORS NOTE: Although the underlying ideas and messages in this article remain relevant, much HIV prevention research has been published since 2014, notably about there being effectively no risk of transmitting the virus if you are HIV positive and undetectable , as well as the effectiveness of pre-exposure prophylaxis . Go to #Prevention, #Undetectable, #TasP and #PrEP for the latest related updates.

Liz Defrain

Theres not a lot of certainty in these numbers. But they can be a good tool for understanding risk.

During sex, our risk perception is replaced by love, lust, trust and intimacy.

Liz Defrain

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Whats The Short Answer

Yes, its possible to get HIV from putting the tip in. And that can be from putting the tip of a penis into the butt, vagina, or mouth.

The risk of getting HIV from the tip varies between the body parts and other factors, like whether youre the one giving or receiving said tip, if one or both parties are taking HIV meds, and more.

Lets break down some common scenarios to help you gauge your risk.

Can I Get Hiv From Anal Sex

  • Anal sex is the riskiest type of sex for getting or transmitting HIV.
  • Being the receptive partner is riskier for getting HIV than being the insertive partner .
  • The bottoms risk of getting HIV is very high because the rectums lining is thin and may allow HIV to enter the body during anal sex.
  • The top is also at risk because HIV can enter the body through the opening at the tip of the penis , the foreskin if the penis isnt circumcised, or small cuts, scratches, or open sores anywhere on the penis.

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Stay On Top Of Medications Including Art Prep And Pep

Weve come a long way in HIV treatment and prevention, and some drugs can help you reduce the risk of transmission if youre living with HIV or are having sex with someone who is.

Talk with a medical professional about:

  • ART: Antiretroviral therapy helps a person living with HIV stay healthy by lowering the viral load. Most people who take it as prescribed can lower their viral load to an undetectable level, so they cant transmit the virus to others.
  • PrEP: A person whos HIV-negative significantly reduces their risk of contracting HIV by taking PrEP consistently.
  • PEP: In the event of potential exposure to HIV, PEP is available for emergency use. It can help prevent HIV infection if started within 72 hours of exposure.

How Can I Make Anal Sex Safer


Use condoms to help protect you against STIs when you have penetrative anal sex.

Use a water-based lubricant, which is available from pharmacies. Oil-based lubricants can cause latex condoms to break or fail.

Get tips on using condoms properly.

Male and female couples should use a new condom if they have vaginal sex straight after anal sex.

This is to avoid transferring bacteria from the anus to the vagina, which may lead to a urinary infection.

Read the answers to more questions about sexual health.

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Can I Get Hiv From Sharing Needles Syringes Or Other Drug Injection Equipment

  • Used needles, syringes, and other injection equipment may have someone elses blood on them, and blood can carry HIV. . HIV can survive in a used syringe for up to 42 days, depending on temperature and other factors.
  • Youre also at risk for getting hepatitis B and C, and other infections if you share needles, syringes, or other injection equipment .

What Should I Know About Anal Sex And Hiv Risk

Anal intercourse when one partner inserts their penis into the other partners anus is a highly risky activity for transmission of HIV as well as other sexually-transmitted infections .

Anal sex partners are usually described as tops and bottoms .

According to the U.S. Centers for Disease Control and Prevention , bottom partners are 13 times more likely to become infected with HIV than top partners.

Why is anal sex so risky?

During anal sex, partners can come into contact with body fluids like blood, semen, pre-seminal fluid, and rectal fluid. These fluids can contain HIV.

Viruses and bacteria can enter the top partners body through cuts and sores on the penis or a finger. Sometimes, these cuts are so small, you dont even know they are there.

The anatomy of the anus makes transmission riskier for the bottom partner. The lining of the anus is thin and does not lubricate like the vagina does. As a result, it can tear, making it easier for viruses and bacteria to enter.

Other STIs, including gonorrhea and chlamydia, can be spread through anal sex as well.

Talking to a doctor

Unfortunately, not all people tell their doctors that they have anal sex. For many, anal sex is taboo and participants are reluctant to discuss it at all. Some feel embarrassed or ashamed.

The study authors encouraged healthcare providers to help patients become more comfortable with the topic of anal sex.

Safe anal sex

People who have anal sex should make sure they do so safely:


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Can You Get Hiv During Sex Without Ejaculation

During penetrative vaginal or anal sex, with no condom being used, HIV transmission is possible even if there is no ejaculation. During sex with an HIV-positive man, transmission is much more likely to occur if he ejaculates, but him not doing so doesn’t make transmission impossible.

Let’s look at some specific scenarios:

Anal sex, HIV-positive person takes the bottom/receptive role — HIV may be present in the lining of the rectum, making transmission to the top/insertive partner possible.

Anal sex, HIV-positive man takes top/insertive role — HIV may be present in pre-cum , making transmission possible.

Vaginal sex, HIV-positive woman — HIV may be present in vaginal fluids, making transmission to the male partner possible.

Vaginal sex, HIV-positive man — HIV may be present in pre-cum , making transmission possible.

Condoms reduce these risks. Similarly, if the HIV-positive person is taking effective HIV treatment, levels of the virus will be so low that transmission is unlikely.

Can Hiv Be Transmitted From A Mother To Her Baby

HIV transmission &  prevention
  • This is called perinatal transmission or mother-to-child transmission.
  • Mother-to-child transmission is the most common way that children get HIV.
  • Recommendations to test all pregnant women for HIV and start HIV treatment immediately have lowered the number of babies who are born with HIV.
  • If a mother with HIV takes HIV medicine daily as prescribed throughout pregnancy and childbirth, and gives HIV medicine to her baby for 4 to 6 weeks after giving birth, the risk of transmitting HIV to the baby can be less than 1%.

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Any Condomless Anal Intercourse Is No Longer An Accurate Measure Of Hiv Sexual Risk Behavior In Gay And Other Men Who Have Sex With Men

  • 1The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
  • 2The Centre for Social Research in Health, University of New South Wales, Kensington, NSW, Australia
  • 3RPA Sexual Health, Sydney Local Health District, Sydney, NSW, Australia

Background: Condomless anal intercourse has long been recognized as the primary mode of sexual transmission of HIV in gay and other men who have sex with men . A variety of measures of CLAI have been commonly used in behavioral surveillance for HIV risk and to forecast trends in HIV infection. However, gay and other MSMs sexual practices changed as the understanding of disease and treatment options advance. In the present paper, we argue that summary measures such as any CLAI do not accurately measure HIV sexual risk behavior.

Methods: Participants were 1,427 HIV-negative men from the Health in Men cohort study run from 2001 to 2007 in Sydney, Australia, with six-monthly interviews. At each interview, detailed quantitative data on the number of episodes of insertive and receptive CLAI in the last 6 months were collected, separated by partner type and partners HIV status .

Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behavior. As HIV prevention enters the era of antiretroviral-based biomedical approach, using all forms of CLAI indiscriminately as a measure of HIV behavioral risk is not helpful in understanding the current drivers of HIV transmission in the community.

What We Know About Vaginal Sex

When a woman has vaginal sex with a partner who has HIV, HIV can enter her body through the mucous membranes that line the vagina and cervix. Most women who get HIV get it from vaginal sex. Even if a womans male partner withdraws or pulls out before ejaculating, she can still get infected because pre-seminal fluid can carry HIV.

More information

On average, an HIV-negative woman has about a 1 in 1,250 chance of getting HIV every time she has vaginal sex with a man who has HIV.

On average, a woman with HIV has about a 1 in 2,500 chance of transmitting HIV every time she has vaginal sex with an HIV-negative man.

For an HIV-negative woman, anal sex is about 17 times more risky than vaginal sex for getting HIV from a partner with HIV.

For a woman with HIV, anal sex is about 3 times more risky than vaginal sex for transmitting HIV to an HIV-negative partner.

If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , their partner has effectively no risk of getting HIV through sex. See how receptive vaginal sex compares to other sexual activities here.

More information

On average, an HIV-negative man has about a 1 in 2,500 chance of getting HIV every time he has vaginal sex with a woman who has HIV.

On average, a man with HIV has about a 1 in 1,250 chance of transmitting HIV every time he has vaginal sex with an HIV-negative woman.

See how insertive vaginal sex compares to other sexual activities here.

More Information

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How To Protect Yourself

Since there is still a chance that you could get infected with HIV through oral sex, you should always take precautions. Here is what you can do to lower your risk:

Do not let a male partner ejaculate in your mouth. You can do this if you remove your mouth from their penis before they ejaculate, or if you use a condom.

Use a condom or dental dam. A dental dam is a thin square piece of latex or silicone that you place over the vagina or anal area during oral sex. You can also cut a latex condom lengthwise and use it the same way.

Both of these barriers also lower the risk of infection from other STDs such as gonorrhea of the throat or hepatitis. Use a new one every time you have oral sex. Check the expiration date on the package, and make sure there are no tears or defects.

Don’t use oil-based products like baby oil, lotion, petroleum jelly, or cooking oil on condoms or dental dams because that can cause them to break. If you need lubrication, use a water-based or silicone-based product instead. Always use a condom or dental dam during your period since the virus can be present in menstrual blood.

Don’t brush your teeth just before oral sex. If you do, your mouth or gums may bleed, which raises chances of infection.

Skip oral sex during risky times. This includes a time when you have sores around your mouth, genitals, or anus , gum damage, a throat infection, or after dental work.

Low/no Risk Sexual Practices

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There are a number of sexual practices that present no or low risk for HIV transmission that you and a partners can enjoy. These include the following:


Massage and rubbing bodies against each other presents no risk of passing on HIV.

RimmingYou cannot acquire or pass on HIV by rimming . However, hepatitis A and gut infections such as shigella are easily passed on this way.

KissingSaliva does not transmit HIV meaning kissing is completely safe.

WatersportsThe terms watersports and piss-play refer to sexual acts involving urine. HIV is not present in urine so watersports carry no risk of HIV transmission.


Oral sexOral sex carries a very small risk for HIV transmission. For more detailed information, check out our Oral Sex page.

FingeringPlaying with someones arse or vagina with your fingers is a low risk activity for passing on HIV. However, trimmed fingernails and thorough hand washing is a good idea to help prevent damage to the wall of the anus or vagina and to lessen the risk of passing or acquiring a sexually transmitted infection .

FistingFisting means inserting your fist in someones arse or vagina. Fists can create serious cuts in the lining of the arse or vagina, which can allow HIV to be passed on if the person being fisted is then fucked without a condom. The person doing the fisting could also get HIV if they have any cuts or scratches. Latex gloves are important for protecting both participants. Surgical gloves are best.

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Tattoos And Body Piercings

  • There are no known cases in the United States of anyone getting HIV this way.
  • However, it is possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone elses blood in it or if the ink is shared. This is more likely to happen when the person doing the procedure is unlicensed because of the potential for unsanitary practices such as sharing needles or ink.
  • If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and that they use only new or sterilized needles, ink, and other supplies.

Receptive Versus Insertive Sex

During anal sex, the partner inserting the penis is called the insertive partner, and the partner receiving the penis is called the receptive partner .

Receptive anal sex is much riskier for getting HIV. The bottom partner is 13 times more likely to get infected than the top. However, it’s possible for either partner to get HIV through anal sex.

  • Being a receptive partner during anal sex is the highest-risk sexual activity for getting HIV. The bottom’s risk of getting HIV is very high because the lining of the rectum is thin and may allow HIV to enter the body during anal sex from body fluids that carry HIV, including blood, semen , pre-seminal fluid , or rectal fluids of a person who has HIV. Using condoms or medicines to protect against transmission can decrease this risk.
  • The insertive partner is also at risk for getting HIV during anal sex. HIV may enter the top partner’s body through the opening at the tip of the penis or through small cuts, scratches, or open sores on the penis. Using condoms or medicines to protect against transmission can decrease this risk.

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