Youth Blog—Ask an Expert: Is It Ever Okay to Have Anal Sex without a Condom?
In our “Ask an Expert” blog series, researchers from the IMPACT Program answer questions from LGBTQ youth. This month’s expert is Dr. Brian Feinstein, a clinical psychologist and a postdoctoral scholar at the IMPACT Program.
Question: If I wash beforehand, is it ok to have anal sex without a condom for protection?
Answer: Good question! Using condoms is a great way to protect yourself and your partner from sexually transmitted infections (STIs), including HIV. If you’re thinking about having anal sex without a condom, then there’s a lot to consider. However, decisions about condom use should not be based on whether or not you’ve bathed. Even if you bathe before or after sex, you’re still at risk for STIs/HIV. Keep in mind that condoms aren’t the only way to protect yourself. There are biomedical HIV prevention methods, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) – click on the links to read previous blog posts about PrEP and PEP!
So, is it ever okay to have condomless anal sex?
The truth is that it’s never 100% safe. People are actually more likely to become infected with HIV from a serious partner compared to a casual partner . This is because people are more likely to have condomless sex with a serious partner. Also, many people who are HIV-positive don’t know that they have HIV, so they stop using condoms in relationships because they think that it’s safe. Even if someone tells you that they’re HIV-negative, it’s possible that they haven’t actually been tested, that they were tested before the virus was detectable, or that they’re not being honest.
Also, some people assume that their relationship is monogamous (both partners only have sex with each other) without talking to their partner about it. If you don’t talk about it, then it’s possible that your partner could be having sex with other people, which would increase your risk. Some guys also think it’s okay to have condomless anal sex if they’re the insertive (“top”) partner. Although receptive (“bottom”) partners are at higher risk, you can still become infected with HIV as the top. Finally, some people think condoms aren’t necessary if both partners are HIV-positive. However, if they have different strains of HIV, then they can still transmit their strains to each other and make their health worse.
Even though it’s never 100% safe to have unprotected anal sex, there are steps you can take to be as safe as possible.
- First, TALK TO YOUR PARTNER about whether or not you want to stop using condoms, what your HIV statuses are, when you were last tested, when you last had sex with someone else, and whether or not you want to be monogamous. Open communication with your partner is key!
- Next, you and your partner each GET TESTED and share your results.
- If you both test negative, then keep using condoms for 3 months, because it can take that long for some HIV tests to detect the virus.
- Then, after 3 months, you and your partner each GET TESTED AGAIN and share your results.
- If you both test negative again, then you should TALK AGAIN and make a decision.
Building trust requires continuous communication and regular testing.
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Medical Information Disclaimer: The IMPACT Program does not intend to provide specific medical advice, but we may provide website visitors with information to better understand their health and risk factors for specific diseases. The IMPACT Program urges you to consult with a qualified health care provider for diagnosis and answers to your personal health questions.
 Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23, 1153–1162.
Cover Photo: Shawn Latta, “Condoms,” 2007