Infectious Disease
Fisting causes trauma and damage to the mucous membranes of the fist chute. A compromised membrane reduces the natural barriers of the immune system and increases the transmissibility of traditional STIs. Apart from STIs, other common microorganisms can also take advantage of a wrecked hole.
Sexually Transmitted Infections and Diseases
Even though fisting (by itself) has a relatively low occurrence of STI transmission, certain practices and behaviors common to fisting sessions can increase transmission risks.
One-on-One Sessions
In one-on-one encounters, a top can transmit certain infections between himself and his partner if alternating his hand between his own genitals and the bottom's fist chute. The risk of a bottom transmitting an STI to a top is relatively low, except when the top has cuts or wounds on his hands.
The most likely route of bottom-to-top transmission is through hand-to-eye contact, and STIs such as Chlamydia, Gonorrhea, and Herpes can be transmitted this way.
Group Sessions
In group fisting sessions involving multiple bottoms, unwashed hands can easily facilitate the transfer of various microorganisms between bottoms. Infections that can easily spread in group sessions include HPV (warts), Hepatitis C, Shigella, Giardia, and Syphilis. However, the risk of transmission can be significantly reduced by practicing good hand hygiene, such as washing hands between bottoms.
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Figure 1.2: Double Decker Increases Risk
The double decker involves two bottoms stacked vertically for penetration by a single top. Hands alternate between holes without hand hygiene. Full video/credit [ 1 ].
Opportunistic Infections
Fisting and cleaning out can lead to compromised natural defenses of the fist chute, characterized by damaged membranes and a reduction in microbiota. Opportunistic infections are more likely to take advantage of the fist chute in this weakened state.
VOCABULARY
Opportunistic Infection
- Noun An infection caused by an organism that does not normally cause disease in people with weakened immune systems.
Pathogenic Potential
- Noun The ability of a microorganism to cause disease in a susceptible host, depending on several factors that include the ability to colonize and invade host tissues; the ability to evade host defenses; and the virulence factors it produces, such as toxins or enzymes that damage host tissue.
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Extreme Pathogenic Potential
These organisms have the potential to cause significant harm once inside the fist chute. Outside the fist chute, they are less dangerous, less infective, or easier to treat.
- MRSA
- C. Diff
- E. Coli
- Monkeypox
- Hepatitis A & B
Mild Pathogenic Potential
Large colonies of bacteria and fungi that are unique to an individual are present in the colon. Normally, these microbiota coexist with the body in a harmless, homeostatic relationship. However, introduction of non-native microorganisms can disrupt this delicate balance, leading to mild symptoms such as diarrhea, rash, and a weakened immune response.
- Candida (Jock Itch)
- COVID-19
- Various Streptococcus





