Introduction Both men and women and transgendered people practice receptive anal sex, and an act of anal intercourse is 10–20 times more likely to transmit HIV than an act of vaginal intercourse. Condoms are effective at preventing HIV acquisition through receptive anal sex, but many people do not use them perfectly for every sex act. Oral HIV pre-exposure prophylaxis is also effective at preventing HIV acquisition through receptive anal sex, but it does not prevent other sexually transmissible infections. Hence there is a need to develop a wider range of tools so that there are options for optimal protection of sexual health for men and women practicing receptive anal intercourse.

Methods This paper reviews the pipeline of products in development that are designed to protect the sexual health of people practicing receptive anal intercourse.

Results A range of products are in development which are designed the rectal use. These products are ‘multipurpose’ technologies primarily as they aim to combine products frequently used prior to or during anal intercourse for ease and pleasure – such as sexual lubricants, and douche and enema  products – for HIV and potentially sexually transmissible infection (STI) prevention purposes. Other products include suppositories and specifically designed applicators  for rectal use. Currently research is focused on antiretroviral-based HIV prevention technologies, but there has also been some research on non-antiretroviral-based products.In addition, there are developments in oral pre-exposure prophylaxis for STIs other than HIV.

Conclusion Given that adherence to interventions is critical to the current HIV prevention tools, building preventative agents into products that people choose to use to enhance the experience of sex may help to optimize adherence.

Disclosure of interest statement No interests to disclose.