Gonorrhea, chlamydia and herpes are passed on during sex, from the penis to the rectum or vice versa. They can also be passed on by sharing sex toys (dildos, vibrators) or, more rarely, by fingers. Anal herpes may also be passed on during rimming.
Your doctor will take a sample from your anus with a swab. The sample will then be tested in a laboratory for gonorrhea and in some cases, for chlamydia. As with urethritis, it may be difficult to tell exactly what kind of infection you have, since the organisms do not always show up in lab tests. Rectal sores should be swabbed for herpes.
If possible, your doctor should use an anoscope when taking the swab, in order to look inside your rectum. Your doctor can also advise you whether it is necessary to test for any other infections.
Gonorrhea can be treated with Suprax; chlamydia and non-specific proctitis with doxycycline. In some cases, no treatment will be necessary.
If you tested positive for gonorrhea or chlamydia, you must have follow-up testing after treatment. Two follow-up tests are needed, since rectal infections are more difficult to test for, and harder to treat successfully. As for sex partners, anyone who performed anal sex on you should be tested and possibly treated.
Condoms, properly used, will protect you against some forms of proctitis (gonorrhea, chlamydia, herpes). Use latex condoms and water-soluble lube only. It’s better not to share sex toys such as dildos, but if you do, use condoms and sterilize them with a bleach solution before and after using them.