In this video you’ll hear real stories of people living with HIV and how they contracted the virus. HIV transmission can happen in an instant, but IT IS PREVENTABLE.
Find more information below on how to take the necessary precautions to protect yourself against HIV.
HOW CAN I REDUCE THE RISK OF GETTING HIV?
HIV can only be transmitted through infected blood, semen, vaginal fluid, rectal fluid or breast milk. The most common ways HIV is transmitted are through condomless sex, or sharing injecting equipment with a person who has HIV. This means you can prevent HIV by taking a look at the prevention options below and making informed decisions about which work best for you.
The HIV preventions landscape has changed. Condoms and lubricant remain the most effective prevention tools against HIV, but they are no longer the only option. ‘Safe sex’ for gay men is no longer restricted to condoms only, but now refers to sex with a very low risk of HIV transmission.
There are now at least five strategies that are reasonably considered ‘safe sex’, provided that certain parameters are met. They are:
- The use of condoms for casual encounters
- HIV negative men taking pre-exposure prophylaxis (PrEP), currently not approved by the Therapeutic Goods Administration (TGA). Click here to find out options to access PrEP in Australia.
- Men living with HIV who have a sustained undetectable viral load (UVL) and no sexually transmissible infections (STIs).
- Use of serosorting between HIV positive men.
- Negotiated safety agreements.
To read more about safe sex and risk reduction strategies click here.
Know your risk
Some guys don’t use condoms all the time and use other methods to reduce (but not eliminate) their risk of contracting or passing on HIV. Knowledge of your HIV status and that of your partners is critical (and disclosure of your HIV positive status, prior to sex, is actually required by law in NSW).
These strategies have varying degrees of effectiveness but are based on many conditions which must be met. For more advice on risk reduction strategies, use the risk calculator here.
Here is a quick overview of the strategies:
SAME STATUS OR SEROSORTING
This is just what it sounds like – you only fuck without condoms with guys who have the same HIV status as you. The thing is, you have to actually know your status and your partner’s to get it right. You can’t guess or assume with this one.
UNDETECTABLE VIRAL LOAD
This refers to the amount of virus present in a positive guy’s blood. If it is classified as ‘undetectable’, it means that the virus is still present; however it is below the level of where tests can pick it up. For HIV positive men, an undetectable viral load, sustained over six months or more, makes HIV transmission much less likely.
This is when the top pulls his cock out of his partner’s arse before cumming. It reduces the risk somewhat over NOT pulling out, however not by much. It’s a high risk strategy.
NEG TOP / POS BOTTOM
This is a relatively simple concept – the negative man tops and the positive man bottoms. While this strategy is certainly lower risk than when the pos guy does the topping, there is still a medium risk of HIV transmission.
This is when two HIV-negative men agree to limit sex without condoms to only between partners within a regular relationship. Any sex with other partners outside the relationship must be with condoms.
NEGOTIATED SAFETY/RELATIONSHIP AGREEMENTS
Negotiated safety describes the situation where two HIV-negative men in an ongoing relationship agree to limit sex without condoms to their relationship, having first established via two tests each that they have the same serostatus. Negotiated safety requires that both parties continue to talk, test, and trust and to maintain a Relationship Agreement that reflects the mutual commitment made and incorporates any mutually agreed changes.
To understand the level of risk involved in each of the strategies, use the Risk Calculator
PrEP (currently not approved by the TGA)
PrEP (pre-exposure prophylaxis) is an HIV prevention approach where HIV negative guys take HIV medications prior to risky sexual encounters to prevent HIV infection. Whilst PrEP is not available in Australia yet, ACON is advocating for this additional HIV preventative tool to be made available here, and there are trials currently being conducted across Australia, including the Prelude Study in NSW.
Condoms continue to provide the most effective barrier against HIV.
Condoms & Dams
Wearing condoms alongside water-based lubricant is the best way to prevent HIV and many other STIs (Sexually Transmitted Infections).
The risk of HIV from oral sex is low, but using a condom or a dental dam can protect you from other STIs. This is especially important if you have a cut or sore around your mouth or lips, or if you have bleeding gums.
HIV can also be transmitted if you share sex toys, so use condoms and change them for each person, or clean the toy thoroughly for each person. Don’t forget to wash your hands after removing the condom.
Don’t be afraid to speak up.
Before you have sex, talk with your partner about using condoms or other ways to reduce your risk. You always have a right to say ‘no’ if your partner doesn’t respect your preferences. If you’re using dating apps and websites to meet people, you can add SSO (safe sex only) to your profile to start the conversation early.
If you’ve been having sex without condoms, it’s not too late to talk about safe sex. You can discuss the risks with your partner and come to an agreement you’re both comfortable with. The decision to have safer sex is important – and it’s always your decision, so don’t stay silent.
Approximately 20% of people living with HIV haven’t been tested and don’t know their status, and most new HIV transmissions are from those who do not know they are positive.
You can’t make assumptions about someone’s HIV status based on the way they look or whether or not they ask to use a condom.
Remember the window period; HIV may take up to 3 months to show up on a test. If you or your partner have engaged in high HIV risk activities since your last HIV test, it’s best to play safe. Get tested regularly, recommended every 3 months if you are engaging in high risk sexual behaviour.
If you think you may have been recently exposed to HIV, accessing PEP emergency treatment ASAP may prevent infection. You must commence PEP emergency treatment within 72 hours after your possible risk exposure – so act quickly and call 13 HEALTH (13 43 84).
PEP is post-exposure treatment and involves a four-week course of medication that is free from most public hospitals or from sexual health clinics.
WHAT IS POST-EXPOSURE PROPHYLAXIS (PEP)?
Post-exposure prophylaxis (PEP) is a treatment that may prevent HIV infection following an exposure to infected blood or bodily fluids. Treatment takes the form of a four-week course of medication that is most effective when taken immediately after exposure to HIV, preferably within 24 hours but no later than 72 hours following exposure.
Think you’ve been exposed to HIV? Act fast.
PEP (post-exposure prophylaxis) is a free 4 week course of treatment that may prevent HIV following a high risk exposure (i.e. condomless sex, condom breakage, sharing injection equipment). If you think you may have been recently exposed to HIV, accessing PEP emergency treatment as soon as possible may prevent infection. You must commence PEP emergency treatment within 72 hours (3 days) after a high risk exposure – so act quickly!
PEP is available free from all sexual health clinics & HIV/sexual health specialist GPs, and most public hospital emergency departments. Use the ENDHIV clinic search tool to find your nearest PEP starter pack provider or call 13 HEALTH afterhours to assess your risk.
Print out this PEP Emergency Card to take with you to public hospital Emergency Departments.
We are currently developing a Queensland PEP Factsheet. Watch this space for more details.
PREP - PRE-EXPOSURE PROPHYLAXIS
PrEP is a new HIV prevention method in which people who do not have HIV take a pill daily to reduce their risk of contracting HIV. As PrEP is a treatment taken before HIV exposure it works by interfering with HIV’s ability to establish itself permanently in the body.
The effectiveness of PrEP has been established by clinical trials conducted in gay men, heterosexual adults and people who inject drugs. The World Health Organisation now recommend that all gay men and others at risk of HIV should consider taking PrEP..
Along with other prevention methods like condoms, PrEP can offer effective protection against HIV.
If you are considering PrEP, discuss this with a doctor with experience in HIV or sexual health. HIV and sexual health clinics and general practices are listed on http://www.endhiv.org.au/clinic-search.
The PrEP fact sheet explains your options for obtaining PrEP through the Australian health system, and how to go about obtaining generic Truvada via the internet if you and your doctor decide that this is your best access option.
TREATMENT AS PREVENTION
Medication now plays an important role in prevention. The role of treatment in preventing onward HIV transmission is known as treatment as prevention (TasP).
Treatment as prevention can be split into two parts:
- Medication can be taken by an HIV positive person with the aim of achieving an undetectable viral load and reduce the possibility of onward transmission of HIV.
- Medication can be taken by an HIV negative person in the form of PEP (post-exposure prophylaxis, see below) or PrEP (pre-exposure prophylaxis) to prevent them from acquiring HIV.
If you or your partner is living with HIV and on antiretroviral treatment, you may have an undetectable viral load. This means that the risk of passing on the HIV virus during sex is very low.
Along with other prevention methods like condoms, being undetectable can offer effective protection against HIV.
Remember that wearing condoms during sex is the only way to stop the spread of STIs (Sexually Transmitted Infections) and also offers additional protection against HIV.
If you’re injecting, protect yourself from HIV by following these tips:
Wash your hands with soap before and after injecting, and before and after touching anyone else.
Swab the injection site with an antiseptic swab, just once, and in one direction (it’s the evaporation that kills germs, not rubbing the area).
After injecting, apply pressure to the vein using a clean cotton-wool ball.
Don’t share equipment. This includes syringes, swabs, cotton wool, filters, tourniquets, spoons etc. This equipment should be kept sterile and never shared with anyone.
Use new, sterile injecting equipment. Stock-up on clean fits from your Needle & Syringe Program or local pharmacy.
Dispose of the used equipment safely. Use a sharps container so there’s no risk of anyone else coming into contact with your fits, cotton wool and swabs. You can get sharps containers from Needle & Syringe Programs (NSP) and some pharmacies.
Pick up the syringe by the barrel, never by the tip.
Don’t try to recap or bend the needle – these are ways people get needle-stick injuries.
To find the location of your nearest Needle and Syringe Program, visit the Queensland Health website.
HIV, hepatitis C and other infections can be passed on through sharing injecting equipment. Clean needles and syringes are available from Needle and Syringe Programs (NSP) across Queensland. For NSP locations visit the Queensland Health website.
For peer support and further information, QuIHN offer a range of services for people whose lives are affected by substance use.
To find out more about HIV prevention visit the END HIV website.