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In its early stages, syphilis is very infectious and can be passed on by close skin contact during sex. In absolute numbers there are more heterosexuals having anal sex in Britain than there are gay men. Listen to America.

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For trans men who still have a vagina and partake in sex with cisgender men, sex may involve penile penetration of the vagina. Problems Erectile dysfunction is being seen increasingly, usually of an organic type, in those with late stage HIV infection, although whether this is an effect of the virus or of the antiviral drugs is not yet clear. Having unprotected penetrative sex is the most likely way to pass on a sexually transmitted infection STI.

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