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Heather Corinna replies:
I have been with my boyfriend 2 years now, we have had anal sex before. I was not aware of the safety factors of it, and we had anal to vaginal sex...alot. I ended up with a horrible UTI and kidney infection. I also had anal herpes outbreak (never had one before.) This was all over a year ago. Anyway, we are trying to introduce anal play back into our sex life.
I am paranoid (as you can imagine) I need your professional advice, and opinions. Do we need to use a condom for anal since we have been together so long, and already figured out that we have herpes? Also...I am paranoid about the infection thing, obviously I'm not even thinking about anal to vaginal sex, but I am still nervous. Please set my mind at ease.
You most likely got the kidney infection because of not treating your urinary tract infection soon enough. Kidney infections almost always arise from a urinary tract or bladder infection, which come about from bacteria introduced to the urethral opening (which, unfortunately, happens to be mighty close to the vaginal opening). If you always treat UTIs -- or other internal infections -- if and when you get them, you won't likely get kidney infections. Too, when you treat the UTIs right away, they won't get as bad as yours did.
A person isn't generally going to get a kidney infection from any kind of sex, in other words. But bacterial vaginal infections and urinary tract infections most certainly can happen when bacteria from the rectum is introduced to the vagina, such as through unprotected anal-to-vaginal sex, or protected anal-to-vaginal sex where your partner doesn't put on a new condom when switching between them. So, there's no need to be worried about getting a kidney infection again so long as you stay current with your yearly sexual health exams, including STI testing, and so long as you also do get healthcare at any sign of infection or genital/urinary discomfort.
Too, it sounds like your partner transmitted genital herpes to you, and if you've never had any other sexual partners before, and you've been together this long without another partner, it's a given he did. If you have had other sexual partners before, especially with unprotected sex (but not always), it's possible -- though less likely, unless you just didn't notice an initial outbreak -- you had the herpes for a while, but only saw that outbreak because your immune system was so stressed out from dealing with the other infections.
Look, if you like anal-to-vaginal sex, if it's something you enjoy, you can still do it, you just need to do it safely. Your partner needs to wear a condom for the anal sex, then switch to a NEW condom before any vaginal sex. Anytime he switches, you need a new condom. And if you like anal sex with fingers, your partner should also be using gloves or a finger cot, and again, will need to switch if he moves his attention to your vulva.
(In case it isn't obvious, if that is NOT something you enjoy for yourself, then even if there were not infection risks, it's not something you should be doing.)
With anal sex, you always want to be using condoms.
Long-time monogamy -- so long as both partners are sticking to it, and are also getting tested for STIs every year -- reduces your risks of most STIs greatly, but the rectum will always have bacteria in it, because feces passes through there. So, you're always at risk of bacterial infections that way, which is why you always want to be using latex barriers. If you're not also using PLENTY of additional lubricant with any kind of anal sex, you can wind up with small tears, abrasions and fissures which increase the chance of infection. As well, anal sex without lubricant tends to feel not-at-all pleasant.
In terms of the herpes, the first thing you both need to do, just so you know the deal, is to find out if he also has it, or already had it. If he's not had an STI test, ever or recently, then your partner needs to do that, and until he's had TWO STI tests where he is clear of all infections (see below for more on the herpes), over a six month period, you'll want to be using latex barriers. If you're not up-to-date with your own STI tests, do tend to that as well, especially since having one infections makes it easier to contract others. Suffice it to say, in the future, you always want to be practicing safer sex for at least the first six months of any new partnership, and only ditching barriers once you both have a couple clear STI tests under your belts (as it were).
If it turns out that you're both free and clear of everything else, and you both DO have genital herpes, then you can't re-infect each other, and going without latex barriers for vaginal sex and oral sex is going to be okay (again, so long as you both stay monogamous) with this partner. If he is NOT found to have it, then you're going to need to start getting in the habit -- a habit you'll need anyway, if you ever have a different partner, which you well might -- of practicing safer sex, full-stop, using condoms and other latex barriers for contact with your genitals. You'll also want to try and keep an eye on your outbreaks, and avoid any genital contact with a partner -- even protected -- when you're getting or have an outbreak. If your doctor didn't talk to you about outbreak suppression medications, have a chat about those: they can reduce outbreaks greatly, which is better for you whether you're sexually active or not.
Here are a few extra links for you to look at, which should give you the information you didn't have before so that things can go a lot safer -- and better -- from now on:
And just so you know? It's not paranoid to have concerns about your sexual health and sexually transmitted infections: it's realistic. Anyone who is NOT concerned either doesn't know about the risks of any kind of sex we have with anyone else, knows but doesn't care about the risks, or is living in a state of denial where they're sure infections are something that happen to everyone but them. It's a GOOD THING you're now having concerns about this, and a GREAT thing that you're planning to safeguard your sexual health from here on out.
P.S. A reader recently wrote in with an excellent suggestion about this I feel incredibly silly for not even thinking of after so many years of providing information and demonstrations on safer sex. That reader said that in their partnership when they want to do this, they use two female condoms: one inserted into the vagina, and the other into the anus. Because female condoms stay tethered into the orifice they're in, that way people can go back and forth if they choose this way without having to keep taking off and putting on new condoms. So, there's another option for you, thanks to Randy. :)