"Truffle Butter" has been a radio and club hit since Nicki Minaj's The PinkPrint was released late last year. Although most of us would hope that the song's title, “Truffle Butter”, simply refers to the expensive French delicacy slathered on meats (as Drake alludes to in his verse), there’s an alternate meaning that has potential real health consequences. According to the Urban Dictionary, the term ‘truffle butter’ refers to the tan substance (feces mixed with excretions) that accumulates around a woman’s vagina when a man removes his penis from a woman’s anus and then inserts his penis into her vagina to continue having sex. Regardless of what the Young Money rappers had in mind, there's been an uptick in cultural conversation about anal sex and this is a good opportunity to talk about some serious safety concerns.
It is well established that fecal matter in the vagina is not sanitary or safe. The most common cause of fecal matter entering a vagina is due to incorrect personal hygiene following a bowel movement. Instead of cleansing in the direction away from the vagina towards the anus, or from the front to the back (the correct way!), one mistakenly wipes towards the vagina from the anus.
In the case of ‘truffle butter,’ to deliver fecal matter into the vagina during sex, potentially puts women at high risk for contracting vaginal infections such as bacterial vaginosis as well as urinary tract infections. There is also an increased risk of infection of the anus and rectum if the couple switches back to anal sex after vaginal sex. It is key to remember that the feces contain lots of bacteria, and that about a third of the content of feces is bacteria, virus, and parasites. In addition, an attempt to create ‘truffle butter’ using no condom, increases the risk of contracting sexual transmitted diseases such as gonorrhea, chlamydia, HIV, genital warts, herpes, and syphilis.
How are these infections contracted?
During sex of any type, the shear forces caused by the penis rubbing on the lining of the vagina or anus causes tiny tears. Theses tears make it much easier for bacteria and viruses from semen, feces, and blood to enter below the lining and possibly enter the blood stream. As a result, anal sex is 30 times more risky for HIV transmission than vaginal sex according to the CDC.
So what can you to make sure you and your partner are being safe? Here are my Doctor’s Orders"
1) Always use a condom: Extensive research continues to show the effectiveness of this method of protection. The barrier provided by latex condoms provides a nearly impermeable barrier to particles the size of STD pathogens. If you have trouble using a condom every time you have sex, learn about pre-and post-exposure prophylaxis–medications that prevent HIV.
2) Avoid having anal sex followed by vaginal sex until you put on a new condom. The same applies if you are using a toy. This will help to significantly reduce the risk of contamination due to traces of fecal matter.
3) Use a water-based lubricant to decrease the risk of anal tears during anal sex.
4) Proper hygiene is essential after anal sex. Be sure to use an anti-bacterial soap.
5) If you are sexually active (oral, anal, or vaginal), please get regular testing for HIV/AIDS and other sexually transmitted infections. Regularly testing is a key component of prevention and also helps to protect those that you care about.
6) Share with a friend or a young person the risks associated with ‘truffle butter.' It is important to share health information on sexual practices that may put individuals at high risk for HIV or STDs.
Dr. Aletha Maybank is a pediatrician board certified physician in preventive medicine/public health. Follow her on Twitter on @DrAlethaMaybank.