Co-factors affecting risk

Published: 30 June 2009
  • Many factors, including stage of infection, sexually transmitted infections and poppers use, can affect the exact degree of risk.

Many co-factors can increase the chance of infection during anal intercourse, including sexually transmitted infections (STIs) in either partner. The effects of STIs have most often been evaluated in population-level trials, rather than tied to specific sexual activities. However, recent anal human papilloma virus (HPV) infection, anal warts and anal gonorrhoea have been found to increase the risk from unprotected anal intercourse among men who have sex with men,1 2 and herpes simplex virus 2 (HSV-2) and syphilis are strongly connected with increased risk.

Poppers are most often (although not exclusively) used during anal sex between gay men, and have been shown to increase the risk for the receptive partner. Rectal bleeding also raises the risk of infection, and could be caused by haemorrhoids, certain STIs such as anal warts, herpes lesions, the prior use of sex toys, or by fingering and fisting. Rectal douching may also increase the risk.

The relation between HIV transmission risk and the viral load of the HIV-positive partner has mostly been studied in heterosexual couples. There have been no prospective studies of the impact of viral load on transmission risk during anal sex.

Related Links

References

  1. Grulich A et al. Anal sexually transmitted infections as risk factors for HIV infection in homosexual men: data from the HIM cohort. Sixteenth International AIDS Conference, Toronto, abstract TUAC0504, 2006
  2. Chin-Hong P et al. Anal human papillomavirus infection is associated with HIV acquisition in men who have sex with men. AIDS (online ahead of print), 2009
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.