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Due to the nature of the area, and the potentially high amounts of bacteria and parasites it can contain, anal sex can carry a higher risk of infection from not only sexually transmitted infections (STIs), but other infections, such as giardia or shigella. For those reasons, condoms are extra important when having anal sex. According to the Centers for Disease Control and Prevention (CDC) more than 90 percent of anal cancer is caused by HPV, an STI that around 40 percent of men in the United States have and for which there is no screening for men.
Bennett recommends using water- or silicone-based lube with latex condoms, since oil-based lube can break down latex. She also recommends putting lube both on the inside and outside of the condom to increase sensation. If using an internal condom, take the inner ring out for anal sex.
Hemorrhoids are enlarged and swollen veins around the outside of the anus or in the lower rectum. Although they can be uncomfortable, Dweck says if bleeding during or after anal sex is caused by hemorrhoids, it usually stops on its own and is nothing to worry about. Also, using plenty of lubricant can help prevent bleeding if you do have hemorrhoids, she says.
If you do bleed during or after anal sex, Dweck says to wait until the bleeding stops and then wash with soap and water if that is comfortable to ensure the area is clean. She also recommends a sitz bath, which can be helpful anyway for someone who needs hemorrhoid relief.
Like all things in sex, you want to prioritize consent, communication, and pleasure during anal. What are you excited to try? What are you not into? Would having a safe word make you feel comfier? Get clear with your partner about what you both are comfortable with. "Talking about anal sex is the same as any other sexual activity," sexologist Dr. Laura Deitsch previously told Bustle. "Be open and honest, figure out how you feel, and what you are looking for."
Heterosexual anal intercourse is rarely discussed in the scientific literature. Review of the literature suggests the silence is linked to ethnocentric discomfort about it among researchers and health care providers, coupled with the misconception that anal sex is a homosexual male practice, not heterosexual. Review of surveys of sexual practices suggest that heterosexual anal intercourse is far more common than generally realized, more than 10% of American women and their male consorts engaging in the act with some regularity. Sexually transmitted disease (STD) data, especially where only the rectum is infected with gonorrhea or other STD agents, buttresses survey data. Considerably more heterosexuals engage in the act than do homosexual and bisexual men, not all of whom participate in anal coitus. Anal intercourse carries an AIDS risk for women greater than that for vaginal coitus, just as receptive anal intercourse carries a very high risk for males. Infection with the AIDS virus is increasingly documented in women engaging in anal coitus with infected males, in America, Europe, and Latin America. Women in Western countries are less likely to continue HIV infectivity chains than are males engaging in same-gender anal intercourse.
PIP: Since the route of transmission of HIV was mapped, the Centers for Disease Control and other authorities have discounted receptive and intercourse in heterosexuals as a significant risk factor: this review concludes that greater numbers of heterosexuals engage in anal coitus than do homosexual men, and that anal coitus carries a greater risk to women than does vaginal intercourse. Several recent studies conclude that the frequency of this behavior is a significant independent predictor of HIV seropositivity. It is probable but unknown whether women having receptive anal intercourse with bisexual men are at a greater risk than those with heterosexual partners. Reading the literature reveals a distinct ethnocentrism in the western medical profession that relegates this practice to homosexuals. A review o anecdotal data, survey data, and magazine and popular surveys indicates that the behavior is common. There are problems with ambiguous terminology, distinguishing receptive sex from anorectal stimulation or rear entry vaginal intercourse. Data on rectal STDs, usually thought to be due to poor hygiene in women, suggest as high as 20-29% solely rectal infections. The conservative conclusion is that 10% of American women engage in anal intercourse regularly. Although the number of women in this risk group of HIV transmission to other partnersis high, female-to-male transmission of HIV is not considered as likely in Western countries as is male-to-male transmission.
Several factors can affect your risk of anal cancer. But having a risk factor, or even several risk factors, does not mean that you will get cancer. Many people with risk factors will never develop anal cancer, while others with this disease may have few or no known risk factors.
Infection by the human papillomavirus (HPV) is the most important risk factor for anal cancer. Most squamous cell anal cancers are linked to infection with HPV. HPV is a group of more than 150 related viruses, the same group of viruses that causes cervical cancer, as well as other kinds of cancer. In fact, women with a history of cervical cancer (or pre-cancer) have an increased risk of anal cancer.
Infection with HPV is common, and in most cases, the body can clear the infection by itself. Sometimes, however, the infection does not go away and becomes chronic. Chronic infection, especially when it is caused by certain high-risk HPV types, can eventually cause certain cancers, such as anal cancer.
Certain types of HPV are called high-risk because they are strongly linked to cancers including anal cancer, as well as cancer of the cervix, vulva, and vagina in women, penile cancer in men, and cancers of the anus, mouth, and throat in both men and women. The high-risk subtype most likely to cause anal cancer is HPV-16. Another high-risk type is HPV-18, but this is seen less often with anal cancer.
People who have had anal warts are more likely to get anal cancer. This is because people who are infected with HPV subtypes that cause anal and genital warts are also more likely to be infected with HPV subtypes that cause anal cancer.
People infected with HIV (the human immunodeficiency virus), the virus that causes AIDS, are much more likely to get anal cancer than those not infected with this virus. For more information see HIV Infection, AIDS, and Cancer.
Smoking increases the risk of anal cancer. The higher a person's pack-year history of smoking, the higher their risk of developing anal cancer. People who currently smoke are more likely to have cancer of the anus compared with people who do not smoke or have quit smoking. Quitting smoking seems to reduce the risk.
Machalek DA, Poynten M, Jin F, et al. Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: A systematic review and meta-analysis. Lancet Oncol. 2012;13:487-500.
People of all gender identities can practice anal douching. But according to a study that looked at over 1,700 people, experts found that anal douching was more common among men. More than 7 out of 10 men douched, whereas over 3 in 10 women anal douched. The study also reported that among men who have sex with men, more than 5 in 10 men anal douched before they had anal sex.
Recent interest in heterosexual anal intercourse has been generated from several research perspectives. In the United States, general population surveys have suggested that the prevalence of anal intercourse among heterosexuals has increased over time (Leichliter, 2008). It is not possible to know from these surveys whether the prevalence of anal intercourse is actually increasing, or as some would suggest that the sexual repertoire of Americans has expanded to include anal intercourse, along with oral and vaginal sex (Leichliter, 2008; McBride & Fortenberry, 2010). There may now be less stigma attached to anal intercourse, and respondents to these general population surveys may be more comfortable admitting to the behavior (Mosher, Chandra, & Jones, 2005). Currently in the United States, there are no states that have laws criminalizing anal intercourse (Kelvin, Smith, Mantell, & Stein, 2009). The increase in the reporting of anal intercourse among heterosexuals has implications for public health efforts to educate individuals about the risks of sexually transmitted infections, including those that may be transmitted through anal contact (Fleming & Wasserheit, 1999; Gorbach et al., 2009; Gross et al., 2000; Halperin, 1999; Javanbakht et al., 2010; Tian et al., 2008).
Interest in anal intercourse has also come from research in human immunodeficiency virus (HIV) transmission. Several studies have quantified the increased risk of heterosexual transmission from one act of anal intercourse as compared to one act of vaginal intercourse (Boily et al., 2009; Leynaert, Downs, & de Vincenzi, 1998; Powers, Poole, Pettifor, & Cohen, 2008). The increased risk of HIV transmission through anal intercourse has been well documented in studies of homosexual and bisexual men; however, there has only recently been interest in documenting comparable risks among heterosexual samples. The studies that have used heterosexual samples have generally focused on parts of the world, such as South Africa, that have not only high rates of anal intercourse among heterosexuals, but also high HIV prevalence in the general population and high numbers of concurrent partners among heterosexuals (Kalichman et al., 2011; Thomas, 2009). Partner concurrency and the higher transmissibility of HIV through anal intercourse also make studying heterosexual anal intercourse compelling in the United States where the prevalence of HIV is high mainly in ethnic minority samples, such as African American and Latina women who have sex with men (McLellan-Lemal et al., 2012; Neblett & Davey-Rothwell, 2011; Reynolds, Fisher, & Napper, 2010). According to the U.S. Centers for Disease Control and Prevention (CDC, 2013), 86 % of HIV cases in women are attributable to heterosexual contact: 65 % of HIV infections in African American women and 17 % of HIV infections in Latina women are attributable to heterosexual contact. Research with women who have male partners recently released from jail or prison has also yielded high rates of anal intercourse (Bland et al., 2012; Swartzendruber, Brown, Sales, Murray, & DiClemente, 2011). Harawa and Adimora (2008) linked high incarceration rates among both men and women in the African American community with HIV through a number of mechanisms, including the role incarceration plays in reducing the number of male sexual partners available to African American women. 2b1af7f3a8