Editing Safe sex (section)

==Anal sex==
Unprotected [[anal sex|anal penetration]] is considered a high-risk sexual activity because the thin tissues of the anus and [[rectum]] can be easily damaged.<ref name="Dean and Delvin">{{cite web|title=Anal sex|vauthors=Dean J, Delvin D|publisher=Netdoctor.co.uk|access-date=29 April 2010|url=http://www.netdoctor.co.uk/sexandrelationships/analsex.htm|archive-date=7 May 2010|archive-url=https://web.archive.org/web/20100507161735/http://www.netdoctor.co.uk/sexandrelationships/analsex.htm|url-status=dead}}</ref><ref>{{cite journal | vauthors = Voeller B | title = AIDS and heterosexual anal intercourse | journal = Archives of Sexual Behavior | volume = 20 | issue = 3 | pages = 233–276 | date = June 1991 | pmid = 2059146 | doi = 10.1007/BF01541846 | s2cid = 13387947 }} as cited in {{cite journal | vauthors = Leichliter JS | title = Heterosexual anal sex: part of an expanding sexual repertoire? | journal = Sexually Transmitted Diseases | volume = 35 | issue = 11 | pages = 910–1 | date = November 2008 | pmid = 18813143 | doi = 10.1097/OLQ.0b013e31818af12f | s2cid = 27348658 | doi-access = free }}</ref>  Slight injuries can allow the passage of bacteria and viruses, including HIV. This includes penetration of the anus by fingers, hands, or sex [[Sex toy|toys]] such as [[dildo]]s. Also, condoms may be more likely to break during anal sex than during vaginal sex, increasing the risk of STI transmission.<ref>{{cite web | title = Can I get HIV from anal sex? | url = http://aids.about.com/od/technicalquestions/f/oral.htm | access-date = 19 August 2011 | archive-date = 3 October 2011 | archive-url = https://web.archive.org/web/20111003004931/http://aids.about.com/od/technicalquestions/f/oral.htm | url-status = dead }}</ref>

The main risk that individuals are exposed to when performing anal sex is the transmission of [[HIV]]. Other possible infections include [[hepatitis A]], [[Hepatitis B|B]] and [[Hepatitis C|C]]; [[intestinal parasite infection]]s like ''[[Giardia]]''; and bacterial infections such as ''[[Escherichia coli]].''<ref>{{Cite web|url=https://www.cdc.gov/hiv/risk/analsex.html|title=Anal Sex |website=CDC|access-date=10 March 2018}}</ref>

Anal sex should be avoided by couples in which one of the partners has been diagnosed with an STI until the treatment has proven to be effective.

In order to make anal sex safer, the couple must ensure that the anal area is clean and the bowel empty and the partner on whom anal penetration occurs should be able to relax. Regardless of whether anal penetration occurs by using a finger or the penis, the condom is the best barrier method to prevent transmission of STI. [[Enema]]s should not be used as they can increase the risk of HIV infection<ref>{{cite journal |vauthors=Carballo-Diéguez A, Bauermeister JA, Ventuneac A, Dolezal C, Balan I, Remien RH |title=The use of rectal douches among HIV-uninfected and infected men who have unprotected receptive anal intercourse: implications for rectal microbicides | journal=AIDS and Behavior |volume=12 |issue=6 |pages=860–866 |date=November 2008 |pmid=17705033 |pmc=2953367 |doi=10.1007/s10461-007-9301-0 }}</ref> and [[lymphogranuloma venereum]] [[proctitis]].<ref>{{cite journal |vauthors=de Vries HJ, van der Bij AK, Fennema JS, Smit C, de Wolf F, Prins M, Coutinho RA, Morré SA |display-authors=6 |title=Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior |journal=Sexually Transmitted Diseases |volume=35 |issue=2 |pages=203–208 |date=February 2008 |pmid=18091565 |doi=10.1097/OLQ.0b013e31815abb08 |s2cid=2065170 |url=https://dare.uva.nl/personal/pure/en/publications/lymphogranuloma-venereum-proctitis-in-men-who-have-sex-with-men-is-associated-with-anal-enema-use-and-highrisk-behavior(6b9b21d8-9369-4f55-a0e5-c6804db29083).html|doi-access=free }}</ref>

Since the rectum can be easily damaged, the use of lubricants is highly recommended even when penetration occurs by using the finger. Especially for beginners, using a condom on the finger is both a protection measure against STI and a lubricant source. Most condoms are lubricated and they allow less painful and easier penetration. Oil-based lubricants damage latex and should not be used with condoms;<ref>{{cite journal |vauthors=Steiner M, Piedrahita C, Glover L, Joanis C, Spruyt A, Foldesy R |title=The impact of lubricants on latex condoms during vaginal intercourse |journal=International Journal of STD & AIDS |volume=5 |issue=1 |pages=29–36 |year=1993 |pmid=8142525 |doi=10.1177/095646249400500108 |url=http://pdf.usaid.gov/pdf_docs/PNACA620.pdf |archive-url=https://web.archive.org/web/20170223025140/http://pdf.usaid.gov/pdf_docs/PNACA620.pdf |url-status=dead |archive-date=23 February 2017 |s2cid=9271973 |citeseerx=10.1.1.574.1501}}</ref> water-based and silicone-based [[lubricant]]s are available instead. Non-latex condoms are available for people who are [[Latex allergy|allergic to latex]] made out of [[polyurethane]] or [[Synthetic rubber|polyisoprene]].<ref>{{Cite web|title=Condoms|date=21 December 2017 |website=NHS |url=https://www.nhs.uk/conditions/contraception/male-condoms/ |access-date=10 March 2018}}</ref> Polyurethane condoms can safely be used with oil-based lubricant.<ref>{{Cite web |title=Clinical Prevention Guidance - 2015 STD Treatment Guidelines|date=10 October 2017 |website=www.cdc.gov |url=https://www.cdc.gov/std/tg2015/clinical.htm|access-date=10 March 2018}}</ref> The "[[female condom]]" may also be used effectively by the anal receiving partner.

Anal stimulation with a sex toy requires similar safety measures to anal penetration with a penis, in this case using a condom on the sex toy in a similar way.

It is important that the man washes and cleans his penis after anal intercourse if he intends to penetrate the vagina. Bacteria from the rectum are easily transferred to the vagina, which may cause [[Vaginal infection|vaginal]] and [[urinary tract infection]]s.<ref name="SHR">{{cite web |title=Anal Sex - Facts and Safe Sex Information |url=http://www.sexual-health-resource.org/anal_sex.htm#aidsanal |access-date=5 April 2010 |archive-url=https://web.archive.org/web/20100404055257/http://www.sexual-health-resource.org/anal_sex.htm#aidsanal |archive-date=4 April 2010 |url-status=dead}}</ref>

When anal–oral contact occurs, protection is required since this is a [[risky sexual behavior]] in which illnesses such as hepatitis A or STIs can be easily transmitted, as well as enteric infections. The dental dam or plastic wrap<ref>{{Cite book|title=HIVAIDS care & counselling : a multidisciplinary approach | vauthors = Van Dyk AC |date=2008 |publisher=Pearson Education South Africa |isbn=9781770251717 |edition=4th |location=Cape Town |oclc=225855360|page=157}}</ref> are effective protection means whenever anilingus is performed.