References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Sexual activities that involve contact with faecal matter — rimming (oral-anal contact), anal sex followed by other activities, or accidental exposure — can transmit infections that aren’t always sexually transmitted in other contexts. Understanding these risks helps you make informed choices and take sensible precautions.
Here’s what to know.
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Infections That Can Spread Through Faecal Contact
| Infection | Transmission Route |
|---|---|
| Hepatitis A | Faecal-oral route; vaccine available |
| Shigella | Faecal-oral route; bacterial diarrhoea |
| Giardia | Parasite causing diarrhoea |
| Cryptosporidium | Parasite causing diarrhoea |
| E. coli | Can cause UTIs and gut infections |
| Campylobacter | Bacterial gut infection |
| LGV (chlamydia) | Rectal infections spread through anal sex and rimming |
| Shigellosis (sexually acquired) | Outbreaks among MSM in recent years |
How Transmission Happens
- Rimming (oral-anal contact) transfers small amounts of faecal matter to the mouth
- Hands contaminated with faeces then touching mouth, eyes or genitals
- Anal sex followed by oral or vaginal sex without washing
- Shared sex toys used without cleaning or covering
What Happens If You Get Infected?
Most faecally transmitted infections cause gastrointestinal symptoms:
- Diarrhoea (sometimes bloody)
- Abdominal cramps
- Nausea or vomiting
- Fever
- Dehydration in severe cases
Hepatitis A causes liver inflammation with jaundice, fatigue and flu-like symptoms. It usually resolves on its own but can be severe.
How to Reduce Risk
Hygiene
- Wash hands thoroughly after any contact with the anal area
- Don’t touch your mouth, eyes or other people’s genitals with unwashed hands
- Wash genitals after anal sex before oral or vaginal sex
- Consider barriers like dental dams for rimming
Vaccines
- Hepatitis A vaccine — free on the NHS for MSM and others at risk
- Hepatitis B vaccine — routine for at-risk groups
Other precautions
- Use condoms on shared sex toys
- Change condoms between anal and vaginal sex
- Consider using disposable gloves for anal play
- Don’t share towels during sex
What If You Develop Symptoms?
- See your GP or sexual health clinic if you have persistent diarrhoea, especially after a sexual encounter
- Stool tests can identify specific infections
- Most bacterial infections respond to antibiotics
- Hepatitis A is usually self-limiting but should be monitored by a doctor
- Stay hydrated and avoid passing infection to others
Shigella Outbreaks in MSM
In recent years, drug-resistant shigella outbreaks have been reported in MSM communities globally and in the UK. Awareness of rimming-related risks and good hygiene are important for prevention. Sexual health clinics can provide advice and vaccination.
Read more: Anal sex and HIV risk | Hepatitis B and C | LGV guide
Frequently Asked Questions
Is rimming safe?
Rimming carries a real but manageable risk of faecally transmitted infections. Good hygiene and hepatitis A vaccination reduce risk significantly.
Should I get the hepatitis A vaccine?
MSM and others at risk can get it free on the NHS. It’s highly effective and offers long-lasting protection.
Can I get HIV from rimming?
HIV risk from rimming is very low, but other infections (hep A, shigella, parasites) are more relevant concerns.
Related reading
- Can You Catch an STI From a Toilet Seat?
- Can You Get Chlamydia From Kissing?
- Can You Get Herpes From a Toilet Seat?
- Can You Get Herpes From Kissing?
- Can You Get an STI if You're Both Virgins?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
