Contrary to some opinions, Anal sex is not a recent development practiced by a select few. Anal play has been around for a long time.

Historically, a number of ancient cultures, namely those in Greece, Rome and Japan, have recorded the practice of male-male and male-female anal sex.

However, from the Middle Ages, anal sex became increasingly taboo, promulgated as dirty and a sin against nature.

This view continues even today, where for most people anal sex has become synonymous with being gay, despite evidence to the contrary. Anal sex suffered a further serious knock in the early 1980…

Anal sex: The risks

With the advent of the HIV epidemic in the early 1980s, anal sex has been highlighted as a significant risk factor in the transmission of HIV. Scientists and prevention specialists constructed what is known as the ‘hierarchy of risk’.

According to this hierarchy, scientific evidence suggests that protected anal sex (that is anal sex with a condom) carries a moderate degree of risk, and unprotected anal sex (that is anal sex without a condom) carries the highest risk for HIV transmission of all sexual activity.

The high risk attached to unprotected anal sex is because of the following reasons:

  • Semen contains a high concentration of the HIV virus;
  • The membranous lining of the rectum (which is very rich in blood vessels) is thin and can easily be torn during anal sexual activity. Such abrasions in the tissue allow HIV to enter into the vascular system in large numbers;
  • In addition, the mucosal tissue in the rectum contains a high concentration of receptors that are ideal for the HI virus to attach itself to; and
  • Even if the lining of the rectum is not torn during anal sex, studies have shown that semen contains two components, collagenase and spermine, that cause the breakdown of the membrane allowing substances to penetrate the rectal and colon mucosa.

Even if engaging in protected anal sex, there is still a significant degree of risk because of the following:

  • Condoms and lube that are not used correctly increase chances of them breaking or slipping;
  • Strong condoms reduce the risk of HIV transmission during anal sex. However, most condoms that are available or freely distributed are ideal for vaginal penetration and are not generally approved for anal sex; and
  • While in the act of having anal sex it is sometimes very difficult to tell whether the condom is still intact or not, until it is often too late.

As such, many gay men have developed their own strategies to reduce their risks. These are as follows:

  • Many men opt to be the insertive partner (a top) rather than a receptive partner (a bottom) as the receptive partner has a greater risk of becoming HIV infected during anal sex than the insertive partner. (The consequence of this approach is that the number of tops could seriously outnumber the available pool of bottoms!)
  • Reducing the number of partners, whether the insertive or receptive partner;
  • Many men are going for regular HIV tests, enquiring about their sexual partner’s HIV status and sexual history, and are negotiating safer sex agreements; and
  • Withdrawing while using a condom before ejaculating.

Anal sex: The pleasures

Despite the risks attached, for many, anal sex appears to take sexual pleasure to a new level. Anal sex can produce a pleasurable and unique sensation due to the stimulation that the partner’s erect penis causes when rubbing or massaging the prostate.

The prostate gland is known as the male “G-spot”. For some, the pleasure of being penetrated is so intense that they are able to reach orgasm without any additional penile stimulation. Discomfort is largely reduced by using plenty of water-based lube.

And things can get interesting when exploring other variations of anal play, namely rimming (licking the anus), finger fucking, and using toys like dildos or butt plugs!

Anal sex: The rate and pattern of involvement among gay men

So, anal sex is risky, yet very pleasurable for so many. But to what extent are gay men actually engaging in anal sex?

There are very few studies that examine the extent to which gay men are having anal sex. According to a report published by the Panos Institute, the rate and pattern of involvement in anal sex (the proportions who are both active/insertive and passive/receptive, active only, passive only, and neither active nor passive) differs (McKenna, 1996). A number of international and national studies have found the following:

  • A survey by the Panos Institute of 133 developing countries found that 72% of respondents indicated that anal sex occurred ‘quite commonly’, ‘very commonly’ or ‘usually’ (McKenna, 1996).
  • According to a survey conducted by the Gay Men’s Health Crisis in New York City, 15% of men reported having no anal sex in the preceding year, 10% only had receptive anal sex, 17% only had insertive anal sex, 50% had both receptive and insertive anal sex, 35% only had anal sex with a condom (Wolfe, 1999).
  • A study conducted by Triangle Project in Cape Town found that 71% of men reported having had some form of anal sex in the preceding year (Boxford, 2001).
  • A study conducted by OUT LGBT Well-being in Gauteng found that 84% of respondents engaged in anal sex, 70% were either/both the receptive and insertive partner, 16% were exclusively receptive, and 14% were exclusively insertive (OUT, 2005).

It is clear from the above studies that the rate and pattern of involvement in anal sexual activity appears to vary greatly. In general, it would appear fairly safe to assume that the rate of anal sex among gay men is between 70 and 85 percent, which is a large majority.

But, perhaps a more important question than “Who is doing what to whom and how often?” is “How important is anal sex in a healthy gay relationship?”

How important is anal sex in a healthy gay relationship?

For many gay men (and society at large) anal sex is intrinsically linked to being gay. But the decision to have anal sex has less to do with sexual identity as it has to do with sexual desire, preference, expression and satisfaction. For many, anal sex is seen as the natural climax or conclusion to a sexual encounter, whether in a steady relationship or a casual encounter.

This appears rooted in the heterosexual notion that penetration is a superior and valid form of sex. In other words you have not fucked until you have penetrated or been penetrated by your partner.

For many, seeking validation in the eyes of society (and in themselves) may have a strong unconscious bearing on their choice to have anal sex. However, for others, anal sex may not be important at all or may simply part of a broader spectrum of sexual acts aimed at achieving sexual satisfaction.

Irrespective of where one positions oneself, the following aspects are important for establishing and maintaining a healthy relationship, whether gay or straight:

  • Intimacy – ability to have a close and warm relationship where one is able to feel vulnerable, yet secure;
  • Communication and openness – ability to continuously talk about and share each other’s thoughts and feelings about anything without fear of being criticised or rejected by one’s partner;
  • Commitment – the act of binding oneself (physically and emotionally) to one’s partner and communicating this to him;
  • Variety – variety is the spice of life! Experimenting and trying out new sexual expressions can enhance one’s sex life dramatically: try stimulating the anus with a finger (or fingers!), tongues, toys or tingling water-based lube.
  • Creativity – this goes with Variety and promotes freshness, excitement, energy, interest and enjoyment;
  • Accommodation and negotiation – this is the cornerstone of any successful relationship and means that both partners need to be flexible and open to each other’s needs;
  • Honesty – the ability to remain truthful and sincere irrespective of the circumstance;
  • Respect – the willingness to show consideration, appreciation and high regard for one’s partner;
  • Integrity – having strong moral and ethical principles that are applied to one’s life and relationships;
  • Loyalty – the expression of devoted attachment and affection;
  • Containment – the ability to hold and be there for one another during significant events, including celebrations, losses and failures; and
  • Security – the ability to offer one another freedom from doubt, anxiety, or fear and promote each other’s confidence, whether together or alone.

Each of these aspects is essential to any healthy relationship. Sex, in any form, should not overshadow any of these aspects but rather enhance them. So ask yourself: “To what extent does your relationship demonstrate the aspects listed above?”

If most of the aspects are present then feel free to discuss and explore whether anal sex (along with all other forms of sexual pleasure) is an important part of you and your partner’s sexual repertoire. Remember. Anal sex is a choice – not necessarily a requirement for a healthy relationship.

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