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Fisting , handballing , fist-fucking , brachiovaginal , or brachioproctic insertion  is a sexual activity that involves inserting a hand into the vagina or rectum. Fisting may be performed without a partner, but it is most often a partnered activity. Fisting's emergence as a popular sexual practice is commonly attributed to gay male culture and it may not have existed until the twentieth century. In the s, it was assumed that unprotected fisting—which often produces small injuries to the anus, permitting microorganisms access to the blood—was an easy route for transmission of HIV. This, combined with sexual squeamishness towards the public fisting culture in gay establishments of San Francisco, led gay writer Randy Shilts to successfully campaign for the closure of venues, such as gay bathhouses and sex clubs, that openly permitted it. The "silent duck", also called "duck-billing", is the technique often used in which the person engaging in hand insertion shapes the hand to resemble a duck's beak. Typically, fisting does not involve forcing the clenched fist into the vagina or rectum; this is a practice called "punching".
Fisting works best when the receiver is already aroused. Warm-up can involve different kinds of stimulation, such as direct or indirect genital or anal stroking, vibration, or penetration. The giver should start with gentle penetration using one or more fingers. Plenty of lubrication should be used along the entire hand, from fingertips to wrist. The giver should move slowly and check in often about what feels good for the receiver. The giver should wait until the receiver is relaxed before trying to gently insert the full hand. Both the receiver and giver can learn to feel when the muscles are relaxed enough to accept an entire hand. Once inside, even the slightest movement can be very intense for the receiver. Gentle movements, including twisting of the hand, can feel good. Experienced receivers may enjoy more vigorous movement, including in-and-out motion.