Gay Men, Bisexual Men, and Other Men Who Have Sex with Men

Pegging is when partner(s) use a strap-on to penetrate another partner.

When you find a toy that is right for you, follow manufacture instructions for storage, use and cleaning. Use lubricant to avoid injury and to enhance pleasure. Use a new condom if you are sharing a toy with a partner. If you have more than one partner at a time, be sure to use a new condom on the toy for each partner who uses it. You can also avoid injuries by checking for any damage before and after use.

Fingering and fisting are not likely to result in the transmission of HIV or other STIs, unless there are injuries. You can reduce the risk of injury or infection by using lubricant, finger condoms, and nitrile or latex gloves.

Rimming, also referred to as a rim job, is to use one's mouth to pleasure someone's anus. Rimming can include licking, tonguing, sucking, kissing, or any oral act.

Mouth-to-anus contact will not usually result in the transmission of HIV or other STIs. However, contact with feces may lead to diarrheal infections and hepatitis A.

Learn what you can do to avoid diarrheal infections.

Douching is the act of cleansing the rectum and anal canal, most traditionally done with liquid expelled from a douche. Douching in preparation for anal sex is a common practice. Douching may cause injury to the lining of the rectum, increasing the risk of some STIs, including HIV, hepatitis B and hepatitis C. It can also put you at higher risk for more common bacterial STIs, such as gonorrhea, chlamydia, syphilis, and HPV. To avoid these risks, use enemas that are available in stores and avoid douching every day or multiple times per day.

• Anal Douching Safety Tips

Do not vaginal douche as it can increase your or your partner's chance of getting infections and pelvic inflammatory disease.

Hemorrhoids are swollen and inflamed veins around your anus or in your lower rectum.

If you are experiencing discomfort and believe you have a hemorrhoid, see your health care provider or visit a local urgent care center.

Anal sex does not cause hemorrhoids, but it can irritate the area and make the condition worse.

Learn more about the symptoms and causes of hemorrhoids.

An anal fissure is a crack or split in the tissues that line your anal canal. It can be a common cause of anal pain and rectal bleeding, especially during bowel movements.

If you believe you have an anal fissure, see your health care provider or visit a local urgent care center.

An anal fistula is an abnormal passageway that develops from the inside of your anus to the skin outside that can become infected. Symptoms can include, but are not limited to, pain, swelling, and redness as well as pus drainage near the anal opening.

If you believe you have an anal fistula, see your health care provider or visit a local urgent care center.

Rectal prolapse is when the rectum loses its normal attachments inside the body and slips through the anus. Failure of the muscles that hold the rectum in place leads to rectal prolapse. Signs of rectal prolapse can be a feeling of pressure or bulge in your anus; a red, fleshy mass hanging out of your anus; and leakage of mucus, poop, or blood from your anus.

If you believe you are experiencing rectal prolapse, see your health care provider or visit a local urgent care center.

Poppers contain alkyl nitrites and are inhaled for recreational use as a muscle relaxant, sex aid, or to induce euphoria. Common brands include “RUSH”, “Jungle Juice” and “Blue Boy”. Poppers are sold in small bottles that can resemble energy drinks.

In the short term, poppers can cause low blood pressure, dizziness, fainting and headaches. Do not ingest poppers and avoid mixing with medications used for erectile dysfunctions. This can lead to serious conditions such as blood poisoning or a heart attack.

Some people use drugs to enhance their sexual experience. This is often called “party and play,” “PnP,” "partying" or "chemsex." Drug use can impair your decision-making abilities. This can lead to needle sharing, higher alcohol consumption, and sex without condoms. These behaviors increase your risk of getting HIV and other STIs.

One form of chemsex is “booty bumping,” or putting a drug (such as crystal meth or cocaine) in the anus to speed up absorption into the bloodstream. Drugs inserted into the anus may cause irritation, bleeding or inflammation, making it easier to pass STIs and HIV.

You can reduce the risk of irritation by diluting the substance with water before inserting it. If you are using a needleless syringe to insert drugs into the anus, always use a clean syringe and do not share syringes.

If you use drugs during sex, use condoms, PrEP, PEP, or HIV treatment to minimize the risk of HIV transmission. People who have chemsex should get tested for HIV and other STIs once every three months.

Just as with any other sexual activity, it is important to have consent before engaging in chemsex.