Women Having Anal Sex and Risk of HIV

Statistics of Women Having Anal Sex and Their HIV Risk

Man handing condom to woman
Man handing condom to woman. Getty Images/Keith Brofsky/Photodisc

Of all sex practices, receptive anal sex carries the highest risk of HIV infection, according to the Centers for Disease Control, or CDC. It's for this reason that numerous prevention messages are targeted to people who engage in unsafe anal sex.

However, while safer anal sex messages are commonly targeted to homosexual men, prevention programs often overlook women — whether they are homosexual, heterosexual, or bisexual.


Let's expand on the statistics and risk of HIV in women who engage in anal sex.

Do Women Have Anal Sex?

Yes, and according to a 2007 study in The Journal of Infectious Diseases, you might be surprised to learn that 30 percent of women ages 15 to 44 years reported that they had engaged in anal sex at some point in their life. 

In addition, in a 2010 study based on data from the New York Community Health Survey, about 105,000 (5.6%) women ages 18 to 64 years reported having anal sex with men in the past year.

What is the Risk of Getting HIV from Anal Sex?

According to the CDC, the chance of getting HIV from a person infected with HIV during receptive anal intercourse is nearly 1.4 percent.

Why Does Anal Sex Carry a High Risk for HIV Transmission?

The anal mucosa is very friable and easily damaged during anal sex.

What Other Risks Does Unprotected Anal Sex Carry?

Anal sex without a condom can spread other sexually transmitted infections (STIs), namely gonorrhea, chlamydia, and syphilis.


Are Woman Using Condoms During Anal Sex?

According to the 2010 study in New York City, only 23 percent of women reported using a condom during anal sex in the prior year, as compared to 61 percent of homosexual men having anal sex.

Are Women Getting Tested for HIV After Anal Sex?

Women who had anal sex without a condom were less likely than those who always used a condom during anal sex to be tested for HIV, according to the 2010 study in New York City.


In addition, while over 90 percent of women who had unprotected anal sex saw a health care provider within a year, only 32 percent of those women got tested for HIV. 

What Else Increases HIV Transmission?

-- Sexually transmitted infections

-- Lack of male circumcision

-- Early or late HIV infection in the person infected with HIV 

What Can We Do?

  • Prevention Educators - it's important to know that women too are engaging in unprotected anal sex. Our messages about getting HIV must change to include this at-risk group.
  • Healthcare Providers - providers must offer HIV testing for their female patients, regardless of the women's perceived risk. During an office visit, providers should address sexual history, including types of sexual practices. With a detailed sexual history in hand, providers can identify those women at highest risk for HIV and other sexually transmitted infections — and offer HIV testing and prevention counseling.
  • People Engaging in Unsafe Anal Sex - unprotected anal sex by a woman is a risky sexual behavior. Among some women, especially among teen girls, anal sex is often viewed as a safe alternative to vaginal intercourse. While that may be true with regards to pregnancy, anal sex carries a higher risk of transmitting HIV than vaginal intercourse. Condoms must be used with each and every sexual encounter, including anal sex. Women must insist on condom use and must do their best to take control of their sexual health.

    More on Safe Sex for Women


    Centers for Disease Control and Prevention. (2014). HIV Transmission Risk. Retrieved October 5th, 2015. 

    Leichliter JS, Chandra A, Liddon N, Fenton KA, & Aral SO. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the U.S. J Infect Dis. 2007 Dec 15;196(12):1852-9.

    New York City Department of Health and Mental Hygiene; Women, Unprotected Anal Sex, and HIV Risk. NYC Vital Signs; Feb 2010; Vol 9 No.2.

    Power KA, Poole C, Pettifor AE, & Cohen MS. Rethinking the Heterosexual Infectivity of HIV-1: A Systematic Review and Meta-analysis. Lancet Infect Dis. 2008 Sep;8(9): 553-63.

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