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Anal sex is the highest-risk sexual behavior for hiv transmission. Vaginal sex has a lower risk, and activities like oral sex, touching, and kissing carry little to no risk for getting or transmitting hiv. The vast majority of men who get hiv get it through anal sex. Even relatively small risks can add up over time and lead to a high lifetime risk of getting hiv. In other words, there may be a relatively small chance of acquiring hiv when engaging in a risk behavior with an infected partner only once but, if repeated many times , the overall likelihood of becoming infected after repeated exposures is actually much higher. Condomless anal intercourse is associated with a high risk of hiv. Being the receptive partnerthe bottomduring condomless anal sex puts a person at a much higher risk for hiv, but its possible for either partner to get hiv. Oral contact with the anus can put both partners at risk for hepatitis, herpes, hpv, and other infections. Learn the relative risk of different sexual activities, and how some factors can increase or decrease the risk of getting or transmitting hiv. There are several key messages that can be given to clients about the risk of hiv transmission through anal sex (where the hiv-negative person inserts their penis into an hiv-positive partners anus) rectal fluid can contain a high concentration of hiv and, if it comes into contact with a partners penis, can lead to hiv transmission. If youre sexually active, you can lower your risk by choosing sexual activities that carry a lower risk for hiv than anal sex. You can do other things to reduce your risk, including taking medicines to prevent or treat hiv and using condoms the right way, every time. If you dont have hiv, being a receptive partner (or bottom) for anal sex is the highest-risk sexual activity for getting hiv. If you do have hiv, being the insertive partner (or top) for anal sex is the highest-risk sexual activity for transmitting hiv. Hiv gets passed from person to person in blood, semen, pre-seminal fluid (pre-cum), fluids from the vagina and rectum, and breast milk.