In this section we describe some of the different ways of having sex. The information is general but includes many different kinds of bodies and how we can help ourselves and each other find sexual satisfaction. Whatever our preferences, respect for ourselves and our partners, communication, and enthusiastic consent are the foundations of sexual pleasure.

It is best not to assume that what feels good for us will feel good for our partners. Things that may impact the ways we experience pleasure include whether a penis is cut or uncut (having or lacking a foreskin can drastically change what feels good), whether we are taking any hormones, whether we have had any surgeries, and whether we tuck using a gaff or wear a soft packer, our past sexual experiences, and so many more. 

While HIV and STIs need to be part of the conversation when talking about sex, they are not the whole picture. There are many ways we can experience sexual pleasure and address HIV and STIs in ways that work for us without letting them overshadow the pleasures that sex can bring. 

Sex can be hot, fun, and intimate no matter what HIV and STI prevention strategies we decide to use. 

Because of these outliers, a sexual health resource could describe activities like rimming (anal oral sex) and fingering as presenting some (but low) likelihood for HIV or STI transmission. On More Than Sex, we describe rimming (anal oral sex) and fingering as having no likelihood of HIV transmission. We do this based on the fact that the there have been no recorded cases of HIV transmission by those kinds of sex. 

When it comes to the HIV and STI transmission, we have to remember that theoretical possibility is not the same as what happens when people actually get together for sex. In other words, what could possibly happen does not mean it is very likely to. Since we are the experts in our own sex lives, we can take information about STIs and HIV and consider whether in the real-life sex we are having there are opportunities for these STIs to be transmitted.

Throughout this section, keep in mind that each STI is transmitted in its own way – what transmits one STI does not necessarily transmit another STI. Anytime we are using prevention strategies from HIV medications as treatment or prevention to condoms, or an STI is not present to begin with, it cannot be transmitted. Understanding STI testing, including the window period, is very helpful when determining whether or not we or our partners may have an STI.

Preparing and Douching

Different people prepare for anal sex in different ways. For some of us a good shower or a thorough cleaning with a wet wipe does the trick. Others may prefer to douche, or prefer that the person we top douches. Douching impacts the lining of our anus, and can create pathways for STIs to enter our bodies through small tears and cuts. Limiting or reducing our douching to as little as possible is recommended.

Because our preferences and expectations can vary so much, it may be important to talk to our partners about this if we do expect them to prepare themselves in a particular way.

Learn the ins-and outs of douching, including a step-by-step guide, here!

Bottoming

It’s important to remember that the anus is a muscle like any other. 

Especially if one of us is new to bottoming, communication, patience, and lube are important tools to make sure everyone enjoys themselves. If we’re using a condom, it’s important to use lube so the condom doesn’t break, and that the lube it is condom-safe.

Just as we stretch when we’re getting ready to exercise, the anus becomes more flexible when we warm it up— that could be with fingers, with toys, with tongues, with any ‘foreplay’ (sex before penetration) that gets us in the mood and helps us relax.

Anal Sex: STIs and HIV

There are a lot of ways that we can have a hot time having anal sex that also make it less likely that we transmit STIs, including HIV. 

In general, sex that involves an exchange of fluids and a penetrating flesh cock present greater chances of transmission. Having anal sex can transmit gonorrhoea, chlamydia, hep B , herpes, HIV, HPV, syphilis, and possibly hep C. Thankfully, there are a lot of strategies we can use to reduce the chance of transmission. HIV and STIs can only be transmitted if we or our partners have enough HIV in our bodies, or an STI is present. Getting tested is the only way to know whether or not we have an STI.

Anal Bottoming: HIV

It is important to remember that it is easier to get HIV and some other STIs when bottoming than when topping, regardless of how the top is penetrating the bottom. The inner lining of the anus and rectum is a large and sensitive mucous membrane, an entry point to the blood stream for HIV and a warm, moist environment for STIs to thrive in.

Bottoming for someone with a penis or “flesh cock”:

Bottoming is one of the sexual activities that are most likely to result in acquiring HIV. There are lots of ways we can bottom without the chance of acquiring HIV: using a condom, taking PrEP, and having conversations with our partners about their STI status and viral load. Having sex when you or a partner has an undetectable viral load means HIV cannot be passed. In addition, having sexual partners who are taking steps to support their sexual health, including taking HIV treatment, regular testing, or PrEP also reduces the chance of acquiring HIV.

Bottoming for a strap-on prosthetic penis or toy: 

There is low likelihood of acquiring HIV by bottoming for a strap-on or toy even without a condom or PrEP. The chances of HIV transmission are considered low because a strapped-on penis does not have a point of exit for viruses. There is a chance of transmission if the penis has topped (penetrated) another person before coming into contact with our bodies, and we have not used a prevention strategy like putting a new condom on or sterilizing the strap-on or toy. This is because the fluids from that partner will still be on the penis and may come into contact with an entry point in the next receiving partner.

Anal Topping: HIV

While it’s easier for HIV to enter our body when bottoming than penetrating (topping), a person topping can also transmit and get HIV.

Topping with a penis or “flesh cock”: 

The inner lining- the urethral lining- of a penis is a mucous membrane that is an entry point to the blood stream, as is the inner sensitive skin of the foreskin for flesh penises that are uncircumcised (uncut). Still, transmission is not as likely as it is when bottoming in the same situation.

When topping with strap on penises: 

Topping with strap on penises is an unlikely scenario to transmit HIV, because HIV cannot live for very long when exposed to air. The only way we may acquire HIV when topping with strap-on penises is if we use that same penis on ourselves while it has another person’s body fluids on it, and we are not using another prevention strategy (PrEP, condoms, or sterilizing the toy between use). This is because the fluids from our other partners will still be on the penis and may come into contact with an entry point inside of us. 

When topping with a meta or phallo penis:

There is little data on HIV and STI transmission for those of us who have had meta (metoidioplasty) or phallo (phalloplasty). 

If and how the urethra is positioned further changes what transmission looks like and how likely it is to happen. If we’ve recently had lower surgery and have skin that hasn’t completely healed, it can be easier to transmit HIV as unhealed skin may provide an entry or exit point for a fluid containing HIV. Having a health care provider who we can talk to openly about our body is the best way to get knowledgeable information on how to prevent our particular bodies from acquiring an STI.

Anal Sex: Preventing STIs & HIV

The most effective way of preventing transmitting or acquiring HIV when having anal sex is using condoms, taking PrEP, or if our partners who are living with HIV and have an undetectable or suppressed viral load. 

Taking PEP after an event where HIV may gotten to an entry point to our body during anal sex can significantly reduce the chances of HIV taking hold in our bodies.

Sometimes those strategies don’t work for the situation that we’re in. There are other ways that we can still reduce the chances of transmission even if they’re not as effective. 

Depending on if we top or bottom, know the HIV status of our partner, have anal sex without ejaculation, have fewer sexual partners, negotiate not using condoms with a regular partner, or maybe choose to have other kinds of sex than anal sex, we can still prevent transmission.

The reality of having sex is that we may one day have an STI. It is nothing to feel bad or ashamed about – just as we don’t feel bad or ashamed when we get the flu. Treating HIV and STIs as “bad” or shameful contributes to stigma. Thankfully, most STIs are curable and all are treatable!

Taking PrEP or having anal sex with partners with undetectable or suppressed viral loads prevents HIV transmission but it does not prevent transmission of other STIs. STIs like chlamydia and gonorrhea are only prevented by using physical barriers such as condoms. Other STIs (specifically herpes,  HPV, and syphilis) require only skin-to-skin contact: even using a condom may not greatly reduce the chances of transmission. 

Especially because we can have an STI without symptoms, the best way to help ourselves and our partners know our STI status is testing regularly.

Not all front holes/vaginas are the same. Everyone – including both cis and trans people – has a unique body. Some of us take masculinizing hormones and/or have surgeries, and some of us do not change our bodies medically or surgically at all. It’s good practice to check in with our partners about what they want sexually, and let them know what we’re into, and not into. This is why communication, patience, and understanding are especially important. 

Taking masculinising hormones can also change what is medically called the clitoris, usually enlarging it and often changing its sensitivity and how we may want to stimulate it. Whether or not we take hormones or have surgery, some of us may refer to the genitals we are born with with different language. For example, some of us may like these external genitals using the words dick or cock in sexual settings, and penis or phallus in medical settings. For some of us, having surgery such as meta (metoidioplasty) can change the way our external genitals look, feel, and we may change the ways we pleasure ourselves. Some of us who have this surgery keep our front holes/vaginas, and some of us don’t: whatever the case, these changes can be very personal, and may change as we get to know our sexual preferences after beginning hormones.

Preparing

Frontal/vaginal sex generally involves lube. If we take masculinising hormones, our bodies may not produce the same amount or consistency of genital lubrication as they used to. Lube reduces uncomfortable friction while protecting our bodies from tears that can make it easier to acquire HIV and STIs, and can heighten sensation for all partners. If using a condom, we will want to choose condom safe lube (water or silicone-based). If we are using silicone prosthetics or toys, we will want to choose oil- or water- based lube.

Contraception & Pregnancy

If we have a front hole/vagina, we may or may not be able to become pregnant when sperm gets inside our bodies. This can happen when we have frontal/vaginal sex with an ejaculating penis.

Whether or not we can get pregnant depends on many factors about our bodies, including what other body parts we do or do not have, and whether or not we are taking gender affirming hormone therapies or have had any gender affirming surgeries. Taking testosterone as hormone therapy alone does not prevent pregnancy. 

If we want to prevent pregnancy, we can use additional forms of contraception. Contraception options include:

• Internal or external condoms.
• Prescription options, such as IUDs, insertable rings, injections, or pills, may allow us more flexibility and control over our own bodies; these are used on an ongoing basis and require a prescription from a physician or nurse practitioner.
• Emergency contraception, available (without a prescription), from pharmacies, and some sexual health clinics or youth clinics.

Many forms of birth control are covered for First Nations people with Status health benefits. Birth control is not covered for most other residents of British Columbia currently, although some provincial plans do offer coverage, and some clinics offer these products at lower cost or free to specific groups (such as youth!). If these options are not available to us, contraception is available to purchase from pharmacies.

Infections

There are a lot of ways that we can have hot and satisfying frontal/vaginal sex while reducing the chances of transmitting STIs including HIV.

In general, sex that involves an exchange of fluids and a penetrating and flesh cocks have greater chances of acquiring or transmitting STIs and HIV. 

Frontal/vaginal sex can transmit gonorrhoea, chlamydia, hep B, herpes, HIV, HPV, and syphilis. Hep C is very unlikely during frontal/vaginal sex. If both ourselves and our partners have a front hole/vagina, we can also pass bacterial vagiosis (BV). There are a lot of strategies we can use to reduce the chance of transmission.

If we’ve recently had lower surgery and have incisions or skin that hasn’t completely healed, it could be easier to transmit HIV as unhealed skin may provide an entry or exit point for a fluid containing HIV.

Frontal/Vaginal Bottoming: STIs & HIV

The partner bottoming using our front hole/vagina has a higher chance of acquiring HIV and other STIs than the topping partner. The inner lining of the front hole/vagina is a large and sensitive mucous membrane, which is an entry point to the blood stream for HIV. It is also a warm, moist environment for STIs to thrive in. 

Reduced levels of estrogen, whether due to masculinizing hormone therapy, menopause, or other factors can also thin the walls of our front hole/vagina. This can lead to small tears during sex not visible to the eye. Also, if our skin hasn’t completely healed following bottom surgery. Both of these may make it easier to transmit HIV as tears and unhealed skin can provide an entry or exit point for a fluid containing HIV. 

If we bottom during anal sex before switching to bottoming with our front hole/vagina with the same partner, make sure that whoever is topping us first cleans their penis or wears and changes condoms before switching holes. Otherwise, bacteria from the anus introduced to our front hole/vagina may cause an infection.

Frontal/Vaginal Topping: STIs & HIV

When topping with an flesh cock:

The person penetrating (topping) a front hole/vagina with a flesh cock can also transmit HIV or other STIs, even if their chances are lower than the bottoming partner. The inner lining of flesh cocks- known as the urethral lining- is a mucous membrane that is an entry point to the blood stream, just like the inner skin of the foreskin for those of us who are uncut (uncircumcised). 

When topping with a strap on penis:

Topping with strap on penises is an unlikely scenario to transmit HIV and STIs because strap on penises do not present an entry point to the blood stream. The only way we may transmit HIV when topping a front hole/vagina with strap-on penises is if we use that same penis on ourselves while it was another person’s body fluids on it, and we are not using another prevention strategy (PrEP, condoms, or sterilizing the toy between use). This is because the fluids from our other partner will still be on the penis and may come into contact with an entry point inside of us. 

When using lube with a strap on penis, double check that it is compatible with what the penis is made of since using silicone-based lube on silicone penises may damage the silicone prosthetic. As well, we can check that our lube is condom safe as some lubes can break down condoms.

When topping with a meta or phallo penis:

We don’t have a lot of data on HIV and STI transmission when topping with flesh cocks post-op from either meta (metoidioplasty) or phallo (phalloplasty) and that don’t ejaculate. We do know that the chances are different for those of us who have had our urethra extended: an extended urethra is a mucous membrane that can be an entry point for HIV. Having a health care provider who we can talk to openly about our body is the best way to get knowledgeable information on the ways we could transmit or acquire STIs and how to best prevent from doing so.

Frontal/Vaginal Sex: Preventing STIs, HIV, and Pregnancy

The most effective strategies to prevent HIV transmission when having frontal/vaginal sex are using a condom, being on PrEP, or if our partners who are living with HIV and have an undetectable or suppressed viral load. If we think we may have had an exposure to HIV and someone else’s body fluids may have entered our body, we may take PEP, which can significantly reduce the chances of HIV taking hold in our bodies.

Sometimes those strategies don’t work for the situation that we’re in. There are other ways that we can still reduce the chances of transmission even if they’re not as effective.

These include choosing sex that isn’t as likely to transmit STIs including HIV, like knowing the HIV status of our partner, have frontal sex without ejaculation, have fewer sexual partners, negotiate not using condoms with a regular partner, or maybe choose to have other kinds of sex than frontal sex.

If someone is going to penetrate our front hole/vagina after penetrating our anus, be sure that they clean their penis or change condoms. Otherwise, bacteria from the anus introduced to our front hole/vagina may cause an infection.

Taking PrEP or having frontal sex with partners with undetectable or suppressed viral loads prevents HIV transmission but it does not stop transmission of other STIs or prevent pregnancy. STIs like chlamydia and gonorrhea are only prevented by using physical barriers such as condoms. Other STIs (specifically herpes, HPV, and syphilis) require only skin-to-skin contact: even using a condom may not greatly reduce the chances of transmission.

Especially because we can have an STI without symptoms, the best way to help ourselves and our partners know our status is testing regularly.

The reality of having sex is that we may one day have an STI. It is nothing to feel bad or ashamed about – we don’t feel bad or ashamed when we get the flu. Treating HIV and STIs as “bad” or shameful contributes to stigma. Thankfully, most STIs are curable and all are treatable!

When it comes to frontal/vaginal sex, another consideration is the possibility of pregnancy.

The only STI prevention method that also reduces the chances of pregnancy is wearing a condom. Having frontal/vaginal sex and pulling out or without receiving ejaculation is not always effective in preventing pregnancy because ejaculation is not necessary for someone to become pregnant, as pre-ejaculatory fluids (pre-cum) can also contain sperm. If we have a post-op dick, or are having sex with someone who does, pregnancy is not possible since post-op dicks don’t ejaculate fluids containing sperm.

There is a common misunderstanding that being on masculinising hormones and no longer menstruating means that we cannot become pregnant, but that is not always the case. Being on masculinising hormones alone is not effective [tooltips content=”Strategies we can use to prevent pregnancy, control monthly bleeding, or otherwise shift our hormones.”]birth control[/tooltips].

Accessing birth control can be a stressful and scary experience when our body, gender, or expression don’t match what may be expected from a health care provider. Having a health care provider who we can talk to about our body is the best way to get knowledgeable information and resources that best match our needs.

Unsure where to start? Check out Options for Sexual Health to learn about birth control in BC, and Trans Care BC for help finding gender- affirming health care and supports across the province.

There are many areas of the body that can be pleasured with the mouth, including the scrotum/balls, the taint (area between the anus and the balls or between the anus and the front hole/vagina), or even areas such as the nipples or feet. This section focuses on oral pleasure of the genitals. 

The best way to have hot oral sex depends on our and our partners’ bodies and preferences. 

Our gag reflex, the size of the cock being sucked, and the sensitivity of the cock or clitoris being licked, are just some of the things that can impact the way that we have oral sex and how much fun it is for both partners. 

Open communication about what kind of sex we want and what feels good is the best way to be sure that everyone is having a good time.

We can also have a hot time pleasuring the anus with our mouth: see our section about ‘rimming’ (anal oral sex) for more detailed information.

Oral Sex: Preventing STIs & HIV

While it’s already very unlikely that any kind of oral sex will transmit HIV, there are ways to prevent transmission even more. 

When giving oral sex, cuts, tears, and sores may be an entry point for our partner’s cum, pre-cum, or frontal/vaginal fluid if they have HIV. Flossing or brushing our teeth can also cause these tiny tears. 

We can also use a condom or dental dam help prevent transmission of other STIs during oral sex. While some people in our communities use condoms during oral sex, many of us do not. If we are choosing to use a condom for oral sex, we may want to look into flavoured options! 

Sterilize prosthetic penises or strap ons before putting it in our mouth after it has been used in someone’s anus, or use a new condom before putting it in our mouth.

Like with anal sex, we may prefer that our anus or the anus we rim is cleaned in a certain way. 

For some of us a thorough clean or douching is absolutely necessary, while some of us prefer a scrub that still leaves a natural musk. If we have expectations about how our partners prepare, it’s up to us to share those with our partner or be prepared for when our partner doesn’t know how to meet them.

 If we’re going to have penetrative sex after rimming, remember that douching can cause small tears and cuts that can make it easier to transmit HIV. 

There is no single way to give a good rim job: all anuses are different and how we like it stimulated is very personal. 

There are a lot of things we can do to increase our partner’s sensation: changing up the pace, the motion of the tongue, whether we’re using the narrow tip or wider part of the tongue further back, if we thrust and push deeper in, paying attention to the area around the asshole and further down toward the genitals, and even using our stubble or facial hair to add a different texture!

Read and listen to the body language of the person we are rimming to see what they’re most getting off on. If being rimmed, try to be responsive with gestures, sounds, or words to let our partner know what’s working and what’s not.

Rimming: STIs & HIV

Rimming is not only a hot way to have sex but also presents no chance of transmitting HIV.

Certain other STIs can be transmitted by rimming, especially STIs that are transmitted by skin-to-skin contact: herpes (HSV), HPV, and syphilis. Because we may come in contact with fecal matter it’s also possible to transmit hep A. Gonorrhoea and chlamydia are less commonly transmitted.

Hep A can be prevented with a vaccine. We can access the vaccine at a doctor’s office or a HIM Health Centre.

The best way to prevent STI transmission is to use a dental dam when rimming our partners. If we don’t have a dental dam handy but do have a condom we can cut it open to make our own. While some people in our communities use condoms during oral sex, many of us do not.

Remember, getting STIs can be a part of having sex. Thankfully, most STIs are curable and all are treatable!

We have a lot of different lube options when using our hands and fingers for sex. This can create a lot of friction which can lead to discomfort or even feeling raw or chafed. Depending on what we’re into and who we’re with, we may need lube—so keep it on hand! Spit can sometimes be used as lube, but it will quickly dry out. 

For those of us on masculinising hormones and having our front hole/vagina fingered or masturbated, it’s important to remember that our bodies may not produce as much lubrication as they used to, and its consistency may have changed. It is also a good idea to ask our partner to wash their hands, and wash ours prior to sex that involves fingering or hand jobs as this may prevent infections such as bacterial vaginosis (BV) or UTIs.

Some of us may prefer to receive hand jobs on prosthetic penises, such as a soft packer or a strap on. It is best to check in with our partners about what they want and enjoy.

Some of us like to use nitrile or latex gloves for fingering or hand jobs. We can check in with our partners regarding what they would like to do and let them know what we want too. Gloves can protect the anus or front hole/vagina from the edges of nails, and can make clean up easier too!

Fingering, ‘Hand Jobs’, and Mutual Masturbation: STIs & HIV

We cannot transmit HIV through fingering, hand jobs, and mutual masturbation. When it comes to STIs, most STIs cannot be transmitted through fingering, hand jobs, and mutual masturbation. Only HPV, herpes, and syphilis may be transmitted through fingering, hand jobs, or mutual masturbation, although this is not likely.

Though the chance of transmission is very unlikely, we may not want to participate in fingering, hand jobs, or mutual masturbation if our genitals or fingers have an open cut, wound, or sore. 

When it comes to fingering, our nails may cause small cuts or tears. Trimming our nails prevents these cuts or tears in our partners’ anus or front hole/vagina. These cuts and tears can be uncomfortable and provide an entry point for HIV to enter the [tooltips content=”Part of the body’s circulatory system that transports blood throughout the body.”]bloodstream[/tooltips] if HIV is introduced to these body parts in other types of sex. 

Depending on our bodies, insertion or penetration may occur when rubbing genitals. In these cases, we may want to consider our sexual health needs in case of penetration.

Anuses, penises, and front holes/vaginas tend to be very sensitive, but everyone is sensitive in different ways. 

Frottage can also occur with gaffs or packers – the choice is up to the individual. Some of us wear a gaff or packer every day, and others do so occasionally. 

The speed, rhythm, lube, tightness of foreskin, and surgeries we may have had are all things that can affect our experiences . Taking it slow and communicating with our partners, whether with words or with our bodies and sounds can help us all have a good time. 

Frottage: Infections

While HIV transmission is considered very unlikely, it cannot be totally ruled out if we are not clothed. That is because without clothes on, there is a potential of exchanging fluids and the urethra, front hole/vagina, and inner skin of the foreskin are mucous membranes that can let HIV into the bloodstream. If we’ve recently had a lower surgery, skin that hasn’t completely healed could also provide an entry or exit point for a fluid containing HIV or another STI. 

The chances of transmitting STIs from frottage, even ones that are transmitted through skin-to-skin (such as human papillomavirus (HPV), herpes, and syphilis) are low as long as there is no penetration to the anus or front hole/vagina. If we have an active outbreak of HPV, herpes, or syphilis, we may want to consider avoiding contact with the outbreak area, or using barriers if possible. 

Frottage where more than one partner has a front hole/vagina can pass bacterial vaginosis (BV).

Caring for Sex Toys and Prosthetics

It’s important we inspect our sex toys and prosthetics when we use them. 

Check for changes in colour, texture, bad smells and black spots that may come from mold or mildew, and cracks that might cause injury or hold bacteria. If our sex or prosthetic is damaged or growing mould or mildew it needs to be replaced.

It’s also important to know the difference between sanitizing and cleaning our toys and prosthetics. 

• Sanitizing means killing all bacteria and viruses that may be on the toy. Doing this eliminates the possibility of transmitting HIV or other STIs when sharing. 
• Cleaning is simply bringing it to a level of cleanliness that satisfies us, best done with soap and water. 

Only toys and prosthetics made with non-porous material can be fully sanitized. 

This is because cleaning solutions aren’t able to penetrate the pores of a sex toy. Non-porous materials include pure silicone, ABS plastic, metal, ceramic, glass, pyrex, medical grade stainless steel, and wood. Just because a toy has silicone in its name does not mean that it is pure silicone and non-porous.

Porous materials include jelly, PVC, vinyl, leather, Cyberskin, Thermoplastics, Thermoplastic Rubber (TPR), Thermoplastic Elastomer (TPE), and Silicone blends, including CyberSilicone, and Silicone-Elastomer Blend, and TPR Silicone. 

Toys and prosthetics, including some porous ones, can be cleaned with a mild antibacterial soap for at least 20 seconds or a specialized toy cleaner. The packaging usually has instructions about how to clean our toy or prosthetic, or we can ask where we bought the toy.

Some toys can be sanitized in a 10% bleach solution (followed by a good rinse!), being wiped down with rubbing alcohol, being boiled for five to ten minutes, or even put through a ‘sanitize’ cycle on a dishwasher for about 10 mins. Don’t put a toy with a motor in boiling water or the dishwasher, these must be hand washed.

After cleaning, let them dry completely before storing them. Any remaining moisture may cause mildew to grow.

Using silicone-based lube with a sex toy made of silicone can damage the toy and immediately make it gummy or feel like it’s melting. We can test if our toy and lube are compatible by putting a spot of lube on the toy before using it. Once we do that, we will notice any negative reaction between them immediately. Check the manufacturer’s website for the most accurate information on lube compatibility. 

There is a very active online community of people using sex toys. Try going online and read about people’s experiences when looking into a specific toy. 

Sex Toys and Prosthetics: Infections

A lot of people don’t know that using a toy to penetrate both ourselves and others can transmit HIV and a lot of other STIs including gonorrhoea, chlamydia,  herpes (HSV), HPV, syphilis, hep B, and hep C. 

A sex toy cannot transmit HIV or STIs if it is only used by one person, whether ourselves or a partner. Using sex toys without penetration cannot transmit HIV or any other STI. 

Inserting sex toys and prosthetics into more than one front hole/vagina, without a new condom or sterilization, can pass bacterial vaginosis (BV).

Sex Toys: Preventing STIs & HIV

If we use a sex toy for penetration, anal or frontal/vaginal fluids can remain on it. The fluids can transmit HIV and other STIs if the toy is then inserted into another partner. 

Using a condom on our sex toy, being on PrEP, if our partners who are living with HIV and have an undetectable or suppressed viral load, or taking PEP after the fact can all reduce or even eliminate the chances of transmitting HIV. Of these, only using a condom with our sex toy also reduces the chances of transmitting other STIs.

Another option is to sterilize our non-porous sex toys in between using them on different partners, though this might not be an option or kill the mood. If a toy is made of porous material, our only real prevention options are to use a condom, not share our sex toy, or to only use it with partners where we have chosen negotiated safety. 

If we decide to use a condom on a sex toy, keep the following in mind:

Condoms that come pre-lubricated often use silicone-based lubes, which can damage and melt some silicone toys. If we’re unsure, use condoms that are unlubricated and our personal lube. 

Some plastic-based and porous sex toys have mineral oils that will damage condoms that are made from latex. In this case, we can use condoms that are made from nitrile or polyurethane.

Also make sure to clean any sex toy that’s penetrated an anus before penetrating a frontal/vaginal. Otherwise, bacteria from the anus introduced to our front hole/vagina may cause an infection.

The inner lining of the anus and front hole/vagina are sensitive mucous membranes that can tear if treated too roughly or pushed too far too quickly. That’s why lube, communication, and patience are necessary tools. 

Generally, thicker water based lube such as J-Lube, K-Lube, or Fist Powder are used for fisting. Some people prefer oil based lubes or creams. Keep in mind that oil based products are not compatible with latex condoms or gloves and will cause them to break down. Nitrile gloves can be used with oil-based lubes instead. Some experienced fisters/fistees make and prepare their own lube recipes – it is a good idea to ask what someone has used in their recipe to ensure it is compatible with our body. 

Not all lubes for anal fisting are good for frontal/vaginal fisting, generally only water based lubes are ideal for front holes/vaginas. Some fisting lubes may contain ingredients that may cause yeast infections for those of us with front holes/vaginas. It is generally best to bring along our favorite lube to a fisting date or discuss this ahead of time. 

Open communication is also very important. The fisting top (“the fister”) needs to know how the partner being fisted (“the fisting bottom” or “the fistee”) is feeling and responding, and often this is done through both verbal and non-verbal communication. It is important to establish some ground rules and key phrases for communication; for example, some partners agree on a ‘safe word’ before starting fisting. This is a code word that both partners know means they immediately pause the action when either says it. 

Fisting: STIs & HIV

It’s unlikely to transmit HIV while fisting or being fisted. Although the inner lining of the anus or front hole/vagina would be an exit or entry point for HIV or an STI to the bloodstream, there isn’t likely an exchange of fluids unless the skin of the fisting partner is somehow broken by a cut.

Though very unlikely, STIs that are transmitted skin-to-skin can be transmitting by fisting: herpes (HSV), HPV, and syphilis.

For those of us on masculinising hormones and having our front hole/vagina fingered or masturbated, it’s important to remember that our bodies may not produce as much lubrication as they used to, and its consistency may have changed. It is also a good idea to ask our partner to wash their hands, and wash ours prior to sex that involves fingering or , hand jobs, or fisting as this may prevent infections such as bacterial vaginosis (BV) or UTIs.

If going from fisting to penetrative anal sex, irritation or tears in our anus from fisting can make it easier for us to acquire STIs and HIV. 

Fisting: Preventing STIs & HIV

Even though transmitting HIV and other STIs is unlikely, it’s still recommended that we wear gloves when fisting. 

A glove provides a barrier in case there are any cuts or wounds on the hand, reducing the already low chances of transmission. More importantly, gloves also provide a smoother surface and help soften the fingernails and any calluses. This makes it more comfortable for the person being fisted. Finally, gloves can make cleaning up afterward less of a hassle. There are several kinds of gloves we might consider wearing.

Even when wearing a glove, it’s also recommended that we keep our nails trimmed and filed and our nail beds smooth and thoroughly washed before getting going. 

Ungroomed nails can irritate and tear the sensitive skin that lines the inside of the anus or front hole/vagina. That could happen without either partner noticing and those cuts or tears would present an exit or entry point for HIV or an STI to the [tooltips content=”Part of the body’s circulatory system that transports blood throughout the body.”]bloodstream[/tooltips] if the person being fisted goes on to bottom with a penis afterward. 

It’s also important to be mindful if switching from fisting a person’s anus to fisting, fingering, or otherwise coming in contact with the person’s fronthole/vagina. If switching from anus and fronthole, make sure to wash our hands and/or change gloves. Otherwise, bacteria from the anus introduced to our front hole/vagina may cause an infection.

Similarly, it’s important to wash our hands and/or change gloves between partners if we are going to fist more than one bottom. While it is unlikely for a fisting top to acquire STIs, some STIs can be transmitted from one bottom to the next if we don’t wash our hands and/or change gloves between partners. These STIs include HIV, hep B, and hep C.

If we notice significant amounts of pain in ways we didn’t anticipate or excessive bleeding after fisting, it is a good idea to seek immediate medical attention.