Fisting: health risks and safety rules

What is fisting?

Fisting means gradually inserting the hand, sometimes the forearm, into a partner’s anus. Sexosafe describes it as a practice of patience and gentleness, focused on pleasure rather than pain, requiring trust and communication.

What are the risks?

Hepatitis C

This is the main infection risk. According to Hépatites Info Service, any practice that can cause bleeding exposes you to hepatitis B and C, and that’s what is seen with fisting done without single-use gloves or with lube shared between several people. HIV rarely passes through fisting itself (CATIE), but other STIs do: gonorrhoea, chlamydia/LGV, shigella.

Injuries

Fissures, tears of the lining, and, rarely but seriously, rectal perforation. A damaged lining also becomes an entry point for infections during later penetration.

Chems

Sexosafe passes on doctors’ warnings: combining fisting with drugs (stimulants, GHB, ketamine) increases the risks: speeding up without noticing, loss of pain sensation, unfelt injuries, sometimes drugs taken anally.

Safety rules

According to Sexosafe and Hépatites Info Service:

1. Nails cut short and filed so you don’t tear the glove or the lining.
2. Gloves: a new glove per partner, and everyone wears their own gloves in group play. Nitrile is tougher and less allergenic than latex.
3. Individual lube: everyone has their own tub, or single doses; in groups, only one person dips into a given tub. No oil-based lube with latex gloves (lube guide).
4. Go slowly: listen to the body; pain is a signal to respect.
5. A proper douche, two hours before, without overdoing it (douching).
6. Sobriety or, failing that, very limited use and experienced partners.
7. Stop at the first sign of bleeding.

When to go to A&E?

After a session, go to A&E straight away if you have:

• intense abdominal pain that persists or gets worse;
• heavy bleeding or bleeding that won’t stop;
• fever, a hard belly, feeling faint.

These may be signs of perforation: every hour counts. Say clearly what happened; staff have seen it before.

For milder injuries (fissure, painful bowel movements), a proctologist can help.

Sexual health

• Vaccines against hepatitis A and B.
• Regular testing, including hepatitis C every 3 months if you fist often.
• PrEP or condoms for penetration that follows fisting.