Safe Anal Sex: Lubricant, Condoms, Preparation and Infection Risk
How to have safer anal sex: lubricant, condoms, preparation, going slowly, HIV and STI risk, testing and when to see a doctor.
In summary
- Plenty of lubricant, always: the anus does not lubricate itself.
- Condom every time, and a new one if you switch to vaginal or oral sex.
- Slowly, with relaxation and communication: pain is a signal to stop, not something to push through.
- The receptive partner has the higher risk of HIV and other infections; PrEP and testing reduce it.
- Ask for throat and rectal tests: a urine test does not detect infections in the rectum.
Anal sex can be pleasurable and safe, but it needs more care than other kinds of sex. The anus does not produce its own lubrication, its lining is thin and tears easily, and it is the type of sex with the highest risk of passing on HIV. With enough lubricant, a condom, time and good communication, most of those risks are greatly reduced.
Why it needs more care
- No natural lubrication: without lubricant, friction causes small tears that hurt and make it easier for infections to enter.
- Delicate lining: the rectal lining is thinner than the vaginal one.
- Higher HIV risk: the US CDC estimates the risk of HIV transmission per unprotected act from a partner with HIV at about 138 in 10,000 for the receptive partner, against 8 in 10,000 for receptive vaginal sex. The insertive partner can also get HIV (about 11 in 10,000).
Before
- Talk about it: agree on what you want to try and on a word or signal to stop. Consent can be withdrawn at any time.
- Hygiene: going to the toilet beforehand and a shower are usually enough. Keep nails short and smooth.
- Have everything at hand: condoms and lubricant.
Lubricant and condom
- Use a water-based lubricant (compatible with all condoms and toys) or a silicone-based one (lasts longer; not suitable for silicone toys). See how to choose a lubricant.
- Avoid oils, creams and petroleum jelly with latex condoms: they can make them break. The WHO stresses that lubricant is especially important in anal sex to prevent condoms from breaking or slipping.
- Do not use numbing products: pain warns you that something is going too fast or hurting.
- New condom when switching from anal to vaginal or oral sex, to avoid carrying bacteria. See the most common condom mistakes.
During
- Start slowly: external stimulation, then a finger or a small toy, before penetration.
- The receptive partner sets the pace and depth. Positions where they control the movement, or side-lying positions, often make this easier: see our anal sex positions.
- Relax and breathe: tense muscles make it uncomfortable. If it hurts, stop, add lubricant or try another day.
- Toys: only those with a flared base, so they cannot slip inside.
Infections and prevention
- Condoms greatly reduce the risk of HIV and most sexually transmitted infections.
- PrEP (medication to prevent HIV) is highly effective; ask a health service whether it suits you.
- Testing: if you have anal sex, ask for rectal and, if you have oral sex, throat tests. See how often to get tested.
When to see a doctor
See a doctor if you have bleeding that does not stop or is heavy, severe or persistent pain, fever, discharge, sores or warts around the anus. If a condom broke and there was a risk of HIV, ask urgently about post-exposure prophylaxis (PEP). For pain during sex in general, see our guide to pain during sex.
Frequently asked questions
Is anal sex safe?+
It can be, with plenty of lubricant, a condom, going slowly and stopping if it hurts. It carries a higher risk of HIV and other infections than other kinds of sex, especially for the receptive partner.
What lubricant is best for anal sex?+
A water-based lubricant, compatible with all condoms and toys, or a silicone-based one, which lasts longer. Avoid oils with latex condoms and numbing products.
Do I need a new condom when switching from anal to vaginal sex?+
Yes. Use a new condom to avoid carrying bacteria from the rectum to the vagina.