Is receptive anal sex the highest per-act sexual risk for HIV?

Receptive anal sex is consistently described as the highest per-act sexual risk when the partner has transmissible HIV and no prevention is used. It is higher risk because rectal tissue is thin and more prone to microscopic tearing, which can create a direct pathway to susceptible cells.

What is the risk for insertive anal sex compared with receptive?

Insertive anal sex is generally estimated lower than receptive anal sex, but it is not zero. Risk depends heavily on partner infectiousness, presence of inflammation or STIs, and whether prevention such as condoms, PrEP, or viral suppression was in place.

If my partner is undetectable, can HIV be transmitted through anal sex?

Public health messaging supports that if an HIV-positive partner is on effective treatment and maintains an undetectable viral load, sexual transmission does not occur (U=U). If you are unsure about your partner’s status or adherence, consider testing and prevention that fits your situation.

How much do condoms reduce HIV risk for anal sex?

When used consistently and correctly, condoms greatly reduce the chance of HIV transmission by preventing contact with infectious fluids. Breaks, slippage, and incorrect use can reduce protection, so technique and fit matter.

How effective is PrEP for anal sex?

With correct use, PrEP dramatically reduces the risk of acquiring HIV through sex. Effectiveness depends on adherence and consistency, and it is often used alongside other prevention strategies such as condoms.

When should I consider PEP after anal sex exposure?

PEP is time-sensitive and is generally most effective when started as soon as possible after a higher-risk exposure, and it is not recommended to start after 72 hours. If you believe you had a higher-risk exposure and you are within 72 hours, seek urgent clinical advice.

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