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I know that anal sex has higher chances of transmitting HIV for both partners.

What I haven't been able to find is if there are risks of unprotected anal sex not present on unprotected vaginal sex, and which are those.

The baseline would be a couple that regularly practices condomless vaginal sex (with other contraception methods). What new risks would them be exposed to when engaging on condomless anal sex?

I think "asume none of the partners have STIs" is a huge stretch medically speaking, but since that's a risk already accepted on condomless vaginal sex, I'm more interested on any other existing risks.

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    Does this answer your question? Is Anilingus healthy?
    – JMP
    Jan 19, 2020 at 3:32
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    @JMP Doesn't answer it for me. I see no mention of all the diseases that can be transmitted by a fecal-oral route, and fecal-oral infections don't even require anilingus.
    – Carey Gregory ♦
    Jan 19, 2020 at 6:55
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    On the subject of intercourse, if you are uncircumcised then take more precautions. It is not just the lining inside the anus/rectum that is more tender/permeable, but also the skin under the male prepuse.
    – Gordon
    Jan 22, 2020 at 2:30

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Your scenario:

A couple regularly practices condomless vaginal sex (with other contraception methods). What new risks would them be exposed to when engaging on condomless anal sex?

You can contract the same sexually transmitted infections (STIs) via the anorectal route as vaginal (see Assi et al. 2014).

The only extra risk I can think of inherent in condomless anal sex is the risk of a Urinary Tract Infection for the person penetrating.

The anus is full of bacteria. Even if both partners do not have a sexually-transmitted infection or disease, bacteria normally in the anus can potentially infect the giving partner. Practicing vaginal sex after anal sex can also lead to vaginal and urinary tract infections. (WebMD, n.d.)

References

Assi, R., Hashim, P. W., Reddy, V. B., Einarsdottir, H., & Longo, W. E. (2014). Sexually transmitted infections of the anus and rectum. World Journal of Gastroenterology: WJG, 20(41), 15262. doi: 10.3748/wjg.v20.i41.15262

WebMD. (n.d.). Anal Sex Safety and Health Concerns. Retrieved from: https://www.webmd.com/sex/anal-sex-health-concerns

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    Additionally there are risks of trauma to the receiver, particularly if not properly prepared.
    – Bryan Krause ♦
    Jan 24, 2020 at 18:02
  • @BryanKrause - If you wish to go down the physical trauma route, that can happen to both the "giver" and "receiver" if care is not taken with or without condom. The same can be said vaginally
    – Chris Rogers
    Jan 24, 2020 at 21:50
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    Physical trauma is still more likely in the anal route though compared to vaginally. The reason that gay men have a higher chance of getting HIV and was actually known as a gay disease back then was because the membrane in the anus is actually more "fragile" so it gets wounded more easily. Thus the receiver is often much likely to get HIV from the giving partner.
    – Pherdindy
    Jan 26, 2020 at 3:10

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