Versatile guys should understand the risks associated with topping (putting your penis in a guy’s anus) and bottoming (putting a guy’s penis in your anus). While topping is lower risk than bottoming, both put you at risk for HIV and other STIs.
Reduce Your Risk
The best way to reduce the risk of picking up or passing on HIV is to use condoms during anal sex, particularly with guys whose HIV status you don’t know or are unsure of or with guys whose status is not the same as yours.
When using condoms, it is a good idea to use lube. Take your time; do not rush it! Rushed or aggressive anal sex can increase the likelihood of tears and other problems.
Knowing your HIV status and that of your partner will allow you to make decisions about how to best reduce sexual risk-taking (this requires regular HIV testing).
Limit Your Partners
Another way to reduce your risk is to limit your number of partners, or establish friends-with-benefits or regular partners who you communicate with and trust.
Sometimes guys forget that semen can be on their hands or faces. Try not to get semen in your eyes. Using someone else’s semen as lube when you masturbate can also be risky. If a finger goes inside your anus, make sure it doesn’t have someone else’s semen on it.
Harm Reduction (may be less risky, but not risk-free)
Guys reduce the spread of HIV in several other ways:
- having less risky sex (hand jobs, oral sex, etc.)
- sero-sorting (looking for partners with the same HIV status)
- strategic positioning (putting the negative guy on top)
- not ejaculating inside eachother (pulling out or withdrawal)
- ensuring that both partners are free of other STIs by getting tested
For HIV-positive guys, proper treatment adherence (taking medication regularly) impacts viral load, which also lowers the risk of passing on HIV.
Undetectable Viral Load
The BC Centre for Excellence in HIV/AIDS and other HIV/AIDS research institutions have found that the risk of HIV transmission for sero-discordant couples (one is positive, the other is negative) is very low if the HIV-positive partner is on treatment, has an undetectable viral load and is free of STIs.