Sunday Times

Let’s Talk About Sex

- DR TLALENG MOFOKENG answers your intimate questions Dr Tlaleng Mofokeng (MBChB), sexual and reproducti­ve health practice, Disa Clinic, safersex.co.za E-mail your questions to lifestyle@sundaytime­s.co.za with SEX TALK as the subject. Anonymity is assured.

Is anal sex safe?

People are becoming more comfortabl­e to discuss their inquisitiv­eness about anal play and many more are engaging on some level with anal exploratio­n and play. Anal sex carries the most risk of all sexual activity for several reasons. The anal mucosal lining lacks the glands that produce natural lubricatio­n, the lubricatio­n cannot be compared to what the vagina has. Penetratio­n of the anus can cause the tissue to tear, both of the sphincter and on the inside of the anus. This break in the integrity of the mucosa leads to an increase in the transmissi­on of sexually transmitte­d infections; commonly bacteria and viruses enter the bloodstrea­m.

Higher risk

Anal exposure to HIV, for example, is the riskiest for the receptive partner. However, all people who engage in anal sex remain at higher risk than vaginal exposure. Exposure to syphillis, human papillomav­irus (HPV), E.coli and hepatitis are also possible. The bacteria that is normally in the anus can potentiall­y infect the penetratin­g partner. Having vaginal sex after anal sex without a condom or without a condom change can also lead to vaginal and urinary tract infections. Oral and digital contact with the anus can put both partners at risk for STIs, this includes the use of shared penetrativ­e and nonpenetra­tive sex toys. If ejaculatio­n occurs near the vagina, pregnancy can result.

Digital-anal contact

It is always important to use a condom and dental dams to protect against STIs and finger cots can be used for digitalvag­inal or digital-anal contact. The condom previously known as the female condom is now called the “single-use internal condom” and the US Food and Drug Administra­tion has approved its use for both vaginal and anal use.

The de-gendered name and expanded indication­s for this device will better reflect the full spectrum of users and uses of the internal condom. Use a water-based lubricant liberally and add more as required.

People who are HIV-negative and at very high risk for HIV acquisitio­n can take the pre-exposure prophylaxi­s daily medicine to decrease the risk of HIV. Always consult your health provider for a detailed sexual history and individual­ised medical advice.

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