Let’s Talk About Sex

Sunday Times - - Pulse - 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 life­[email protected]­day­times.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.

www.123rf.com/Daria Kov­tun

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