How Is PIV Sex Risky for Those Involved?

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PIV sex is shorthand for "penis in vagina" sex. In other words, it's another term for vaginal intercourse. Many people define sex as PIV sex. This definition is problematic. Sex for most individuals is also composed of many other activities — including oral sex, anal sex, and mutual masturbation. This is true even for heterosexuals who engage in PIV sex as a regular part of their sex lives. However, it is particularly true for gay, lesbian, and other sexual and gender minority individuals, as well as those heterosexual couples who chose not to engage in PIV for one reason or another. When people define sex as only vaginal intercourse, it diminishes the value of other forms of sexual activity. It also makes those types of sex more difficult to discuss.

When sex educators discuss PIV, they are usually referring to vaginal intercourse involving a cis-gender man and cis-gender woman. Some people will also describe strap-on sex as PIV, although that usage is rare.

Also Known As: vaginal intercourse, heterosexual sex

Alternate Spellings: P-I-V

Examples: PIV sex is the only type of sex that, when practiced by heterosexuals, carries a significant risk of pregnancy. However, almost all forms of sex, including PIV sex, can put participants at risk of STDs.

STD Risk

PIV sex comes with a number of risks. In addition to pregnancy, all of the common STDs can be transmitted during this type of sexual activity. In general, the risk of transmission from male partner to female partner is higher than vice-versa, but both partners are at risk of getting an STD during PIV sex. It is particularly important to note that, although in the U.S. HIV is associated with anal intercourse and injection drug use, that is not true everywhere. Worldwide, heterosexual, vaginal intercourse is the leading cause of HIV transmission.

It is possible to reduce the risk of transmitting or acquiring an STD during PIV sex. However, it requires consistently and correctly using either a male condom or a female condom every time you have sex with someone who might have an STD. For many couples, that means practicing safe sex every time they have sex because realistically speaking anyone can have an STD.

Outside of the context of a mutually monogamous relationship, where both people have been appropriately screened for STDs, and no one has strayed or otherwise put themselves at risk, PIV should be considered a potentially risky form of sex. Furthermore, even in the aforementioned circumstances, PIV sex can put couples at risk of an unexpected or unwanted pregnancy, which means that contraception is always a good idea... even if couples decide they do not want to use condoms.

A Note on Gender Identity 

Not everyone with a penis is male, and not everyone with a vagina is female. Therefore, sometimes non-heterosexual, non-cis-gender couples may have PIV sex as well. The risks, in these circumstances, are similar to those for heterosexual, cis-gender couples. However individual health, hormonal, and anatomical factors can potentially impact risk. 

Debunking Myths About Orgasms and PIV Sex

There is a misconception that all women can orgasm from PIV sex alone. It's a myth. Orgasm also says nothing about how and whether women enjoy PIV sex. Many women who sincerely enjoy PIV sex cannot orgasm without additional clitoral stimulation. That doesn't mean that there's anything wrong with them, or the sex that they're having. It also says nothing about their emotional maturity. Freudian arguments aside, psychology does impact sexual behavior, but so does biology.

To put it simply, individuals are wired in different ways. For some people, deep vaginal stimulation during intercourse feels better. Others prefer stimulation of the clitoris. A 2017 study of over one thousand women in the US found that only 18 percent said they had orgasms from PIV sex alone. Thirty-six percent reported that they needed clitoral stimulation. Another thirty-six percent said they could orgasm with PIV sex, but that clitoral stimulation made their orgasms better. Everyone's body is different. So is what they enjoy during sex. Some people want intensity and orgasms. Others prefer a slow build and decline. 


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