prevention. Aids and heterosexual anal intercourse. This includes by the use of anal toys. Is it possible to develop a product without this stigma, or better, one that is felt to enhance pleasure? International Journal of STD and aids. A b c Vittinghoff, E; Douglas, J; Judson, F; McKirnan, D; MacQueen, K; Buchbinder, SP (1999). 7 Non-penetrative sex edit Main article: Non-penetrative sex A range of sex acts, sometimes called "outercourse can be enjoyed with significantly reduced risks of infection or pregnancy. Apart from the STI transmission risks, other risks such as infection are high regarding anal intercourse. 21 Periodic STI testing has been used to reduce STIs in Cuba and among pornographic film actors. They reported that Nonoxynol-9 lubricant do not have enough spermicide to increase contraceptive effectiveness cautioned they should not be promoted. For those who are not monogamous, reducing the number of one's sexual partners, particularly anonymous sexual partners, may also reduce one's potential exposure to STIs. Contrary to medical best practice, PrEP is sometimes used by those who do not wish to use condoms or who intend to have condomless sex. I only want to create citations. 42 Anal sex is practiced by many heterosexuals, as well as homosexual couples.