Bottom and top

CDC tok say any of di two partners fit get HIV during anal sex (sex for nyash/anus), but if you be di bottom, wey mean say your partner penis dey inside your rectum (back passage), e dey make am more likely for you to get am. For each act, wit partner wey get HIV and no dey take treatment, di estimate be:

  • Receptive anal sex (di person wey dem enter, bottom): 1.4% (around 1 out of 72)
  • Insertive anal sex (di person wey dey enter, top): 0.11% (around 1 out of 910)

To compare, receptive vaginal sex na 0.08% (around 1 out of 1,200) for each act. Dis na average: di first time fit pass HIV, and plenti acts fit no pass am.

Between men

Wen two men do sex and nobody sabi di partner status, di main tin wey dey change di estimate na how common HIV dey among men wey dey sleep wit men. UNAIDS estimate say gay men and oda men wey dey sleep wit men dey about 23 times more likely to get HIV pass di general population. Di calculator dey use dat number by itself for sex between men.

For one act without condom wit man wey im status no dey known:

  • Bottom, United States: 0.05% (around 1 out of 2,000)
  • Top, United States: 0.004% (around 1 out of 25,000)
  • Bottom, United Kingdom: 0.01% (around 1 out of 9,800)

Circumcision dey reduce men risk to get HIV through vaginal sex, but one Cochrane review find say di evidence for men wey dey sleep wit men no clear. Read more for our guide for gay and bisexual men.

Between man and woman

Di calculator dey use di same number for each act for any receptive partner. For woman wey do receptive anal sex wit man wey get HIV and no dey take treatment, e be 1.4% (around 1 out of 72), wey high well well pass vaginal sex wit di same partner.

Wit man wey im status no dey known for United States, woman estimate for one act of receptive anal sex na 0.0024% (around 1 out of 42,000). For man wey do insertive anal sex wit woman wey im status no dey known for dat place, e be 0.00019% (around 1 out of 530,000).

Wetin dey reduce di risk

  • Condom. For real life use, even wit di times wey condom comot or burst, condom dey reduce risk by about 80%. Bottom wit condom and partner wey get HIV: 0.28% (around 1 out of 360).
  • PrEP. PrEP (pre-exposure prophylaxis: HIV medicine wey you dey take before any exposure to protect yourself) na medicine wey pipo wey no get HIV dey take to prevent am. If you take am di way dem prescribe, e dey reduce di risk from anal sex by about 99%. Bottom wey dey take PrEP well well, wit partner wey get HIV: 0.014% (around 1 out of 7,200). Di options na daily tablets, tablets wey some men wey dey sleep wit men dey take around di time of sex (event-driven), and injection wey dey last long. See PrEP and PEP.
  • Treatment. Partner wey get HIV and im viral load (how much HIV dey di blood) dey undetectable (di HIV for blood don low reach where test no fit see am) no dey pass HIV through sex. See U=U.
  • No ejaculation inside. Di calculator dey reduce di bottom estimate by 50% wen di top no release (ejaculate) inside.

Wetin dey raise am

  • Oda STIs. Sore and swelling from infections like syphilis, gonorrhea or herpes dey make am easy for HIV to enter. Di calculator dey multiply di estimate by 2 for STI (sexually transmitted infection, wey be infection wey dey pass through sex).
  • New infection. For di first weeks afta person get HIV, im viral load dey reach di highest, and many times e neva even know. Di calculator dey raise di estimate 10 times.

Wetin to do now

You be bottom or top without condom for di last 72 hours? If your partner get HIV and no dey take treatment wey dey work, or you no sabi im status, ask about PEP (post-exposure prophylaxis: HIV medicine wey you go take afta exposure to stop di virus) now for emergency department (A&E) for hospital, urgent care or sexual health clinic. You must start am within 72 hours, and di best na within 24. How to get PEP

  1. Face PEP first if you still dey inside di 72 hours. No wait for test result. You go take PEP every day for 28 days.
  2. Do test afta di window period (di time afta infection wen test neva fit show HIV). NAT (nucleic acid test, wey dey look for di virus itself) fit find HIV from 10 days. Lab antigen/antibody test (blood wey dem draw from vein) go give negative result wey don be final from 45 days. If you take PEP, expect follow-up test about 4 to 6 weeks and 12 weeks afta di exposure (wen HIV fit don enter your body). See how test correct week by week.
  3. Do STI check. Anal sex fit pass oda infections too, and if you get one, e go raise HIV risk for next time.
  4. Plan ahead. If you dey do anal sex without condom, or wit partners wey you no sabi dia status, e good to ask about PrEP: na protection wey you yourself dey control.