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 might affect decisions around the sex you want, and the sexual health strategies you’re using.

Getting fucked (bottoming) makes acquiring HIV more likely because fluids that carry HIV, like cum, are able to cross very easily through the thin lining of the ass. This is more likely when the top has a high viral load. This may be because he has undiagnosed HIV, or for other reasons doesn’t have a low or undetectable viral load.

Getting fucked frontally (vaginally) is also a common way people acquire HIV. However, for trans guys, we don’t know for sure how hormones affect the chance of transmission through the front hole (vagina). toppingAndBottoming_bottoming_buttguyIt is possible that hormones may increase the chance of transmission because of dryness or other effects on the front hole (vagina). Always use lube and check out our resources about HIV and STIs at

Some HIV-positive guys think that they won’t have to worry about the transmission of HIV if they’re always bottoming. Although there is a lower likelihood of transmission when an HIV-positive partner is bottoming, HIV can still enter the top’s body through the tip of his cock. This is especially true if the top has a foreskin, because there are cells in the foreskin that HIV can use to establish an infection.

If you want to bottom, learn about how to reduce the HIV risks by using PrEP, undetectable viral load, or condoms as sexual health strategies.