August 2019 Issue #32 August 2019 Issue #32 | Page 153

HIV prevention
Several strategies can reduce the risk of HIV transmission through anal sex (where
the insertive partner is HIV-negative), including condoms, post-exposure prophylaxis
(PEP), pre-exposure prophylaxis (PrEP), antiretroviral therapy (ART), and (potentially)
penile circumcision.
The HIV-negative insertive partner can use condoms, PEP or PrEP to reduce the risk
of HIV infection through anal sex. Condoms are a barrier that can prevent the penis
from coming into contact with HIV in the rectum,18,19 while PEP and PrEP can reduce
the risk of infection if an exposure to HIV occurs.20,21 All of these strategies are highly
effective at reducing the risk of HIV infection if used consistently and correctly.
Circumcision (the removal of the foreskin) of someone who is HIV negative may be
able to reduce the risk of them becoming infected through insertive anal sex with an
HIV-positive partner. Some research suggests circumcision can reduce the risk for
HIV-negative gay men who primarily take the insertive role during anal sex. However,
the extent of the reduction in transmission of HIV transmission, if any, is unclear and
requires further research.22 The effect of circumcision on HIV transmission during anal
sex with a female partner has not been researched among heterosexual men.
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