HIV prevention

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HIV prevention

About HIV prevention

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Overview

Today, more tools than ever are available to prevent HIV. In addition to limiting your number of sexual partners, never sharing needles, and using condoms correctly and consistently, you may be able to take advantage of newer biomedical options such as pre-exposure and post-exposure prevention.

Am I at Risk?

People who are at the highest risk for exposure to HIV are:

  • Anyone who is in an ongoing relationship with an HIV-positive partner.
  • Anyone who is 1) not in a mutually monogamous (also known as a “closed” or “exclusive”) relationship with a partner who recently tested HIV-negative, and 2) is
    • a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months; or
    • a heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners)
  • Anyone who has injected illicit drugs in the past 6 months and who have shared equipment or been in drug treatment for injection drug use in the past 6 months.

Preventing HIV through Safer Sex Practices

Choose less risky sexual behaviors, limit your number of sex partners, use condoms, use medicines to prevent HIV if appropriate, and get checked for sexually transmitted diseases (STDs). The more of these actions you take, the safer you can be.
Specifically, you can:

  • Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex. Anal sex is the highest-risk sexual activity for HIV transmission. If you are HIV-negative, insertive anal sex (topping) is less risky for getting HIV than receptive anal sex (bottoming). Sexual activities that do not involve the potential exchange of bodily fluids carry no risk for getting HIV (e.g., touching).
  • Use condoms consistently and correctly.
  • Reduce the number of people you have sex with. The number of sex partners you have affects your HIV risk. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission.
  • Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting PEP immediately and taking it daily for 4 weeks reduces your chance of getting HIV.
  • Get tested and treated for other STDs and encourage your partners to do the same. If you are sexually active, get tested at least once a year. STDs can have long-term health consequences. They can also increase your chance of getting HIV or transmitting it to others.

If your partner is HIV-positive, encourage your partner to get and stay on treatment. ART reduces the amount of HIV virus (viral load) in blood and body fluids. ART can keep people with HIV healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently and correctly. 

Preventing HIV through Correct Condom Use

When used correctly and consistently, condoms are highly effective in preventing HIV infection.

This means using a condom every time you have sex. Condoms are also effective at preventing sexually transmitted diseases (STDs) transmitted through body fluids, like gonorrhea, chlamydia, and HIV. However, they provide less protection against STDs spread through skin-to-skin contact like human papillomavirus (genital warts), genital herpes, and syphilis.

There are two types of condoms: male and female.

Male Condoms

  • Latex condoms provide the best protection against HIV. Polyurethane (plastic) or polyisoprene (synthetic rubber) condoms are good options for people with latex allergies. Natural membrane (such as lambskin) condoms are porous, meaning that infections can pass through them, and therefore do not protect as well against HIV and certain other STDs.
  • Lubricants can help prevent condoms from breaking. Water-based and silicon-based lubricants are safe to use with latex condoms. Oil-based lubricants and products containing oil, such as hand lotion, Vaseline, or Crisco should not be used with latex condoms.

Female Condoms

  • Female condoms are thin pouches made of a synthetic latex product called nitrile.
  • When worn in the vagina, female condoms are just as effective as male condoms at preventing STDs, HIV and pregnancy. Some people use female condoms for anal sex. However, we do not know how well female condoms prevent HIV and other STDs when used for anal sex. But we do know that HIV cannot travel through the nitrile barrier.
  • It is safe to use any kind of lubricant with nitrile female condoms. 

Although highly effective when used consistently and correctly, there is still a chance of getting HIV if you only use condoms, so adding other prevention methods can further reduce your risk.

Preventing HIV through Safer Sex Practices and Medicine

The Centers for Disease Control (CDC) recommends taking medication before exposure (called pre-exposure prophylaxis, or PrEP) for people who are HIV-negative and at substantial risk for HIV. Currently, only one drug, Truvada, is approved for this use.

If you are taking PrEP, you should not stop using condoms. If PrEP is taken daily, it offers a lot of protection against HIV infection, but not 100%. Condoms also offer a lot of protection against HIV infection if they are used correctly every time you have sex, but not 100%. PrEP medicines don’t give you any protection from other infections you can get during sex (like gonorrhea, chlamydia, and hepatitis), but condoms do.

So you will get the most protection from HIV and other sexually transmitted diseases if you consistently take PrEP medicine and consistently use condoms during sex.

For more information, see the Truvada DrugFactBox.

Source

Centers for Disease Control and Prevention. HIV/AIDS Prevention. Published January 16, 2015.

Centers for Disease Control and Prevention. HIV/AIDS PrEP. Published June 25, 2015.

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