Some guys prefer either topping or bottoming, and may choose their sexual health strategies based on their preference. Other guys choose to top or bottom as a way of reducing the chance of HIV transmission, because the guy who is topping is less likely to acquire HIV.

Though better than doing nothing, this kind of “strategic positioning” on its own is not as effective as other sexual health strategies like condoms, PrEP or undetectable viral load. A lot of guys choose to top or bottom in combination with one or more of these strategies, which can make this approach highly effective.

Here’s what you need to know about bottoming and topping as sexual health strategies.


A guy who is bottoming is more likely to acquire HIV than a guy who is topping. A lot of guys like to do both, so whether you’re getting fucked this might affect decisions around the sex you want, and the sexual health strategies you’re using.

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It’s less likely for a guy who is topping to acquire HIV, but transmission can still occur. How does this fit into decisions around sex?

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Oral Sex

Oral sex is not very likely to end up in HIV transmission, regardless of whether you’re giving or receiving.

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Making decisions about topping and bottoming

Are you topping, bottoming, or both? Your sexual position may affect your decisions about sexual health.

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