HIV and Safer Sex 1

What Safer Sex Is

Most people know that serious, even life-threatening, infections like HIV, syphilis, and other sexually-transmitted diseases (STDs) can be passed from one person to another through sex. Safer sex is sex that reduces the chances of spreading or getting STDs. It involves certain actions (e.g., using a condom) that prevent person-to-person sharing of the bodily fluids that can spread STDs. Choosing to have safer sex shows that you care about the pleasure and health of yourself and your sexual partner(s).

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What Safer Sex Is Not

Safer sex is not only for the prevention of new HIV infections. For people living with HIV (HIV+), safer sex is important because it can prevent infection with other STDs that can weaken the immune system. If both people are HIV+, safer sex can also reduce the possibility of getting infected with another strain of HIV that is resistant to the drug regimen you are taking.
Safer sex does not have to be boring or bland. Safer sex can be fun, exciting, and very pleasurable. It can decrease your worry about getting or spreading STDs, which can in turn make your sex more relaxed and satisfying. It is also a great chance to add variety to your sex life and to build trust and intimacy with your partner by talking about each other's desires.

Practicing Safer Sex

Practicing safer sex involves knowing what bodily fluids can spread STDs, what sexual activities are risky for each person, and how you can make that activity less risky. These bodily fluids include blood, vaginal secretions, and semen (cum and pre-cum).
Since every sexual act that involves sexual fluids or blood has at least some risk, safer sex means using barriers to prevent passing fluids into another's body. Barriers include condoms (male and female), dental dams (thin squares of latex), and latex or nitrile gloves. Barriers can help reduce the risk of spreading or getting STDs by keeping one partner's fluids from getting into or onto the other partner. There are also several sexual activities that do not pass sexual fluids or blood between bodies and therefore have very little or no risk.
It can be helpful to know which sexual acts are more risky than others. The risk for a specific sexual act is determined by what bodily fluids are being exchanged and what part of the body is involved. Below is a list of common sexual activities, their risks, and tips for making them safer:

Vaginal-Penile Sex

Receptive vaginal-penile sex, or heterosexual intercourse, is considered a high-risk activity. It is also considered the most common way that HIV is spread worldwide. While it is high risk for both women and men, HIV+ men are much more likely to spread infection to women than HIV+ women are to infect men.
The best way to make vaginal-penile sex safer is to use a condom (rubber). There are two main types of condoms: male condoms and female condoms. Most male condoms are made of latex; some are made of polyisoprene (a type of plastic) or lambskin. Lambskin condoms can prevent pregnancy; however, they do NOT prevent the spread of HIV. Only latex and plastic condoms prevent the spread of HIV.
Male condoms come in a variety of shapes, sizes, colors, textures, and even tastes. They are generally inexpensive and can be found at pharmacies, grocery stores, and sex stores. Sometimes they are available for free at certain health clinics and AIDS-service organizations. They are also quite small and easy to carry with you so that you can always be prepared to protect yourself.
Female condoms are made of latex or polyurethane and can be put inside the vagina before you begin sexual activity. They usually cost a bit more than male condoms and are available at pharmacies, grocery stores, and sex stores. They are also available for free at certain health clinics and AIDS service organizations.
To make vaginal-penile sex even safer, consider using lubricant (‘lube'). Lube can prevent the condom from breaking and also helps prevent small cuts or tears in the vagina and on the penis during penetration. Lube is good for un-lubricated condoms as well as ones that come already lubricated; sometimes the lubrication on the condoms is not enough.
When using latex condoms, use only water- or silicone-based lube. Do not use oil-based lubes like Vaseline, Crisco, shea butter, or baby oil with latex condoms because they weaken the condom and make it more likely to break. Silicone-based lube will last longer than water-based lube. Lube can also make the condom feel better. There are several types and brands of lubes, with a variety of different feels and tastes. Some also contain substances that ‘warm' or enhance sensation.
If you are not using a condom, you can avoid getting semen in the vagina by having the man pull out before ejaculating (cumming, reaching orgasm). It is important to know, however, that HIV can be in pre-cum, the fluid that comes out of the penis before orgasm. Therefore, having the man pull out before orgasm is not a guarantee that you will not get HIV or other STDs spread through male sexual fluids.

Anal-Penile Sex

Receptive anal-penile sex is a high-risk activity. While the risk for the insertive male partner is much lower than for the receptive partner, it is still risky. As with vaginal-penile sex, the best way to make anal-penile sex safer is to use a condom and lube.
When using latex condoms, use only water- or silicone-based lubricant to prevent the condom from breaking and help the condom feel better. Lube will also help prevent small cuts or tears to the rectum, anus, or penis during penetration. Do not use oil-based lubes like Vaseline, Crisco, shea butter, or baby oil with latex condoms because they weaken the condom and make it more likely to break. There are several types and brands of lubes, with a variety of different feels and tastes. Currently, there is research going on to look at which type of lube is best for anal sex. However, there is not enough evidence yet to make recommendations about which lube is safest.
If you are not using a condom, you can avoid getting semen in the anus by having the man pull out before ejaculating (cumming, reaching orgasm). It is important to know, however, that HIV can be in pre-cum, the fluid that comes out of the penis before orgasm. Therefore, having the man pull out before orgasm is not a guarantee that you will not get HIV or other STDs spread through male sexual fluids.