- With condom and lubricant LOW RISK *
- Without condom HIGH RISK
* Condoms are not 100% reliable. There is enough evidence of transmission due to condom breakage or improper use to classify this activity as low risk.
Transmission to the male partner during unprotected penile-anal intercourse may occur in one of two ways. Minor or microscopic cuts or tears on the penis may allow the virus to enter, and sores on the penis (e.g. genital ulcers) can pose even more risk by providing a point of entry for the virus. There is also evidence that transmission can occur directly through the mucosal lining of the urethra (through the opening at the tip of the penis) or of the foreskin.