Can I get HIV from anal sex?
Yes. In fact, unprotected (without a condom) anal sex (intercourse) is considered to be very risky behavior. It is possible for either sex partner to become infected with HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus. In general, the person receiving the semen is at greater risk of getting HIV because the lining of the rectum is thin and may allow the virus to enter the body during anal sex. However, a person who inserts his penis into an infected partner also is at risk because HIV can enter through the urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open sores on the penis.
Not having (abstaining from) sex is the most effective way to avoid HIV. If people choose to have anal sex, they should use a latex condom. Most of the time, condoms work well. However, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. A person should use generous amounts of water-based lubricant in addition to the condom to reduce the chances of the condom breaking.
Working with clients, I provide this information and accentuate the risks involved. This is true for men and women, no matter what their erotic orientation.
For information purposes, Laumann et al found that 25% of men and 20% of women reported anal sex. Among gay and bisexual men, 76% of the survey respondents had experienced insertive anal intercourse and 82% receptive. This was in 1994, I suspect the numbers are higher among straights now.
To me, this means that straights need the CDC information and some gays do not engage in anal sex (although they need the information as well). Assumptions that all gay males do this routinely, while often correct, are not always true. Frequency of such activities and with whom are important factors for health care professionals to ask about and they are the determinants of disease, not sexual attractions per se. My view is that sexual promiscuity in gay men owes more to being male than being attracted to the same sex. Of course, this is not proven but it fits my clinical experience and observations better than assuming the reverse.
There are people of both sexes and all sexual orientations who are at high risk for acquiring and spreading STDs. These individuals often have significant emotional needs and profit from interventions that are individually suited to their needs.
Take away point: People who do not manage their intimate lives well are at higher risk for disease and emotional distress than those who do.