Is Anilingus safe?

Soooooo, I know a lot of people don't necessarily admit to doing this, despite it being a totally acceptable (and I hate to use the word, but) normal sexual practice, since it isn't talked about frequently, I wanted to talk about the risks and how to be safe.  Technically, Anilingus is oral-anal sex (AKA "rimming", "rim job", etc.) and is the act of kissing, licking, and/or putting the tongue into the anus.  There are risks along with this practice and ways to do it safely.

What are the risks?

Well, firstly, there is always a risk with any form of unprotected sex for HIV (and yes, oral sex "counts" as sex in the medical world), that being said, the risk is very low for this practice, as long as your there are no bleeding gums, hemorrhoids, open sores, other STDs present.  Any time there are other STDs present, and you or your partners HIV status is unknown, there is a higher risk for transmission due to a portal of entry and a weakened immune system. Other than that, there are risks of other STDs such as gonorrhea, syphilis, chlamydia, herpes (HSV 1 & 2), genital warts (HPV), Hepatitis A, Hepatitis B, Hepatitis C, E. Coli, and parasites.  Specifically Hepatitis A and E. Coli is transmitted through the oral fecal route (which is why you are encouraged to wash your hands after using the restroom, changing diapers, picking up dog poop, etc); you will usually get some pretty decent diarrhea, and then it will pass in a few days (like a viral infection, but there is a risk for an E.Coli infection to get pretty serious, and if that is the case, then please see your HCP.)  The parasites and other STDs will require a trip to your HCP and a treatment with antibiotics to treat them, although we all know that herpes is the gift that keeps on giving, and you will need a diagnosis so that you can learn how to prevent breakouts and how to be sexually healthy with herpes and prevent transmission.  With HPV, not only are the warts an issue, but I urge you to read my earlier blog related to oral cancer and HPV (having more than 5 partners for oral sex increases your risk of oral cancer by up to 250%)!  As you may know, Hepatitis C is a chronic disease than can cause liver failure, to which their is no cure currently, and it is transmitted just like HIV/AIDS. Hepatitis B can also be transmitted like HIV/AIDS and Hep C, but most people (approximately 90%- per the Hepatitis B Foundation) will get the virus with few to no symptoms and rid the body of the virus and create antibodies against it, as well many healthcare workers and people at risk for bodily fluids are vaccinated against it.

How can I prevent these risks?

So there are a couple of different options to decrease your risks, but knowing the HIV and STD status of your partner is key!  If you don't know their status and/or you don't really care, you need to use protection.  How?  I am sure that you don't have a dental dam in your back pocket, although it is deemed as the best form of protection because it is created for oral sex (cunnilingus/anilingus). 

If you don't have a dental dam, you can cut a condom open and use that as a dental dam, and here is a link to instructions to doing it properly.  And if that isn't an option, you can always use saran wrap in a pinch.  Saran wrap has never been officially studied and accepted by the medical community as a "prescribed" barrier method, but it is a barrier and better than nothing.  Due to it being thicker than a condom or a dental dam, you can have decreased sensation, but it is much safer than going without!  To decrease the risk of fecal/oral transmission of E. Coli and Hepatitis A, some people use and enema to clean out their anus before anilingus and feel safe that the risks are decreased, so it is safe not to use protection.  Honestly, it does decrease the risk, but it doesn't eliminate the risk completely, because the bacteria/viruses usually are present still around and inside the anus. 

I am also not saying that you will get sick from doing this every time, but there is a risk of it happening, and with new partners, there is always a risk of STDs.  If you are in a monogamous relationship and don't want to use any barrier, just make sure that the areas are clean before going in for the kill to prevent as much oral-fecal transmission as possible :)

So, enjoy yourself, but be responsible and keep it clean kids!!

Yours in Good Health

B