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Anal sex, if practised with care, is possible for most couples. It does, however, carry additional health risks and there are safer sexual practices that couples can enjoy. The main health risks, which affect both heterosexual and homosexual couples, are described below.
Human immunodeficiency virus (HIV): there is no doubt that anal intercourse carries a greater risk of transmission of HIV - the virus that can cause acquired immunodeficiency syndrome (AIDS) - than other sexual activities, particularly for the receptive partner.
Human papilloma virus (HPV, wart virus): this can be transmitted during anal intercourse and lead to anal warts, which in turn could perhaps predispose infected individuals to cancer of the anal canal.
Hepatitis A (infectious hepatitis): this is a viral infection that can cause jaundice and abdominal pain. Hepatitis A is not usually a life-threatening illness, although sufferers can feel quite ill. It can be transmitted by oral-anal contact.
Hepatitis C: is a cause of progressive and sometimes fatal chronic liver disease. Hepatitis C may be transmitted by anal intercourse, although this seems to be a rare occurrence. Sharing of equipment for intravenous drug use is a far more important risk for transmission.
Escherichia coli (E. coli): may sometimes cause mild to severe, or even (rarely) fatal, gastroenteritis. It is one of many viruses and bacteria that can be transmitted by oral-anal contact. Some E. coli strains (uropathic E. coli) can also cause urinary tract infections (UTIs), ranging from cystitis to pyelonephritis - a serious kidney infection. E. coli very readily crosses the short distance between the female anus and the female urinary opening, so causing a urinary infection. Anal intercourse can facilitate this ‘transfer’ – particularly if it is immediately followed by vaginal intercourse
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