Risks for men vs women and insertive vs receptive?

Q: Are risks different for men vs women?

A: In heterosexual vaginal or anal sex, if other factors are equal, a woman has a biologically higher risk of infection compared to a man.

• The surface area of the vagina or anus is far greater than the surface area of the penis.
• The risks of tears to the vagina or anus during sex is greater as the these inner linings are more delicate than the skin on the penis.
• The length of time of exposure of the vagina or anus to semen is greater than the time the penis is exposed to the vaginal fluid or rectal mucosa.

Q: Are risks similar for insertive vs receptive anal sex?

A: The risk for anal sex, if other factors are equal, is greater for a receptive partner compared to an insertive partner.

• The surface area inside of the anus, is larger than the surface area of the penis
• The risks of tears to the anus during sex is greater as the membrane on the inside of the anus is more delicate than the skin on the penis
• Pre-cum and cum will stay in the receptive partner for longer than the insertive partner is in contact with rectal tissue and mucosa.

If viral load is undetectable, there is no risk of HIV.

PrEP also protects against HIV.

Last updated: 1 June 2021.