AV (anal sex, also known as "A-Levels") refers to anal intercourse. It is offered by some sex workers as an optional service, usually for an additional fee and always with a condom and lubricant. Preparation (hygiene, slow foreplay) is essential—professionals take their time.
Risks: Micro-injuries significantly increase the risk of STI transmission (especially HIV and hepatitis C). Changing condoms between anal and vaginal/oral sex is mandatory. If there is pain or bleeding: stop immediately.