Your Guide to
Healthy Living With HIV www.patientedu.org/hiv
afer sex is just as important for people living with HIV as it is for those who are not infected. Practicing safer sex offers many benefits. It will increase the communication and trust between you and your partner. It also helps prevent getting infected with other STDs and lowers your chances of getting re-infected with drugresistant strains of HIV. In this brochure, find out how you can have safer sex while reducing your risk of spreading HIV to others and protecting yourself from other infections.
How HIV Spreads During Sex In order to spread HIV during sex, HIV infection in blood or sexual fluids must be transmitted to someone. Sexual fluids come from a man’s penis or from a woman’s vagina. It can occur before, during, or after orgasm. HIV is transmitted when infected fluid gets into someone’s body. You can’t spread HIV if there is no HIV infection. If you and your partners are not infected with HIV, there is no risk. If there is no contact with blood or sexual fluids, there is no risk. However, be careful. An undetectable viral load does not mean that there is no HIV infection. HIV needs to get into the body for infection to occur.
Unsafe Activities Unsafe sex increases your risk of spreading HIV. The greatest risk occurs when blood or sexual fluid touches the soft, moist areas inside the rectum, vagina, mouth, nose, or at the tip of the penis. These parts of the body can be damaged easily. When this happens, it gives HIV a way to get into the body. Vaginal or rectal intercourse without protection is very unsafe. Sexual fluids enter the body. Wherever a man’s penis is inserted, it can cause small tears that make HIV infection more likely. The other partner is more likely to be infected. HIV might be able to enter the penis, especially if it has contact with HIV-infected blood or vaginal fluids for a long time or if it has any open sores. Some men think that they can’t transmit HIV if they pull their penis out before they reach orgasm. This is not true. HIV can be in the fluid that comes out of the penis before orgasm.
Reduce the Risk Most sexual activity carries some risk of spreading HIV. To reduce the risk, you can take measures to make it more difficult for blood or sexual fluid to get into your body:
Be aware. Examine both your own body and your partner’s for cuts, sores, or bleeding gums. These can increase the risk of spreading HIV. Rough physical activity also increases the risk. Even small injuries give HIV a way to get into the body.
2) Use a barrier.
Barriers can help prevent contact with blood or sexual fluid. The body’s natural barrier is the skin. If you don’t have any cuts or sores, your skin will protect you against infection. However, in rare cases, HIV can get into the body through healthy mucous membranes. The risk of infection is higher if the membranes are damaged. The most common artificial barrier is a condom for men. You can also use a female condom to protect the vagina or rectum during intercourse.
3) Consider lubricants.
These products can increase sexual stimulation. They also reduce the chances that condoms or other barriers will break. Oil-based lubricants (eg, Vaseline, oils, or creams) can damage condoms and other latex barriers. Use water-based lubricants instead. Source: TheBody.com (www.thebody.com/content/art6098.html).
Condoms will only protect you from HIV and other infections when used correctly and consistently.
Safer Activities Safe sex activities have no risk for spreading HIV. Abstinence—never having sex—is totally safe. Sex with just one partner is safe as long as neither one of you is infected and if neither one of you ever has sex or shares needles with anyone else. Drug and alcohol use is a major factor in the spread of HIV infection and has been linked with unsafe sexual activity. Equipment for using drugs can carry HIV and other infectious organisms.
What to Do If Both People Have HIV Some people who are HIV-infected don’t see the need to follow safer sex guidelines when they are sexual with other infected people. However, it still makes sense to “play it safe.” If you don’t, you could be exposed to other sexually transmitted infections, such as herpes, human papillomavirus (also known as HPV), or syphilis. If you already have HIV, these diseases can be more serious. Choosing a sex partner based on their HIV infection status is a practice called “sero sorting.” Published studies have shown that this is not a very effective way to reduce the risk of HIV infection. A concern for sexual partners who are both infected with HIV is that one or both individuals might get “re-infected” with a different strain of HIV. This new version of HIV might not be controlled by the medications you are taking. Furthermore, it might become resistant to other antiretroviral drugs. There is no way of knowing exactly how risky it is for HIV-positive people to have unsafe sex.
Tips for Using Condoms Effectively: • Store condoms away from too much heat, cold, or friction. Don’t keep them in a wallet or in a car glove compartment. • Check the expiration date. Don’t use outdated condoms. • Don’t open a condom package with your teeth.
Debunking Condom Myths Myth
“Condoms don’t work.”
Studies show condoms are 80% to 97% effective in preventing HIV transmission if they are used correctly every time you have sex.
“Condoms break a lot.”
Less than 2% of condoms break when they are used correctly. This means using no oils with latex condoms, no double condoms, and no outdated condoms.
“HIV can get through condoms.”
HIV cannot get through latex or polyurethane condoms. Don’t use lambskin condoms. Source: TheBody.com (www.thebody.com/content/art6019.html).
However, following guidelines for safer sex will reduce the risk. This includes not using alcohol or drugs before or during sex. Be very careful if you have used any alcohol or drugs because it greatly increases the chances that you will not follow safer sex guidelines.
• Use a new condom every time you have sex, or when the penis moves from the rectum to the vagina. • Check the condom during sex, especially if it feels strange, to make sure it is still in place and unbroken. • Do not use a male condom and a female condom at the same time.
- Be careful that your fingernails or jewelry don’t tear the condom.
• Use only water-based lubricants with latex condoms, not oil-based. The oils in Crisco, butter, baby oil, Vaseline, or cold cream will make latex fall apart.
- Body jewelry in or around your penis or vagina might also tear a condom.
• Use unlubricated condoms for oral sex. Source: TheBody.com (www.thebody.com/content/art6019.html).
To be safe, assume that your sex partners are infected with HIV.
Think Ahead, Set Your Limits Sometimes a little thinking ahead can go a long way toward preventing problems later on down the road. Before engaging in sexual activities, decide how much risk you are willing to take. Know how much protection you want to use during different kinds of sexual activities. Do the following before you have sex: • Think about safer sex.
No matter what, be sure to know your limits. Don’t let alcohol or drugs or an attractive partner make you forget the importance of protecting yourself. You owe it to yourself and your partner!
For More Information If you still have questions, the following resources offer more information about safer sex and HIV:
Centers for Disease Control and Prevention www.cdc.gov
• Set your limits. • Get a supply of lubricant, condoms, or other barriers. • Be sure lubricant, condoms, or other barriers are easy to find when you need them. • Talk to your partners so they know your limits. • Take stock of the people you’re surrounding yourself with. Do they have your best interests in mind?
World Health Organization www.who.int/hiv
Joint United Nations Program on AIDS www.unaids.org/
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To learn more about HIV and AIDS, visit Healthy Living With HIV at: www.patientedu.org/HIV.
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