Safer Sex and HIV
An overview


AIDS and HIV

What is HIV/AIDS? 

HIV stands for Human Immunodeficiency Virus. AIDS stands for Acquired Immunodeficiency Syndrome and is caused by infection with HIV. A person who is HIV-positive (HIV+) has been infected with HIV. Otherwise, it is known as being HIV-negative (HIV-). 

Acquired Immune Deficiency Syndrome (AIDS) is the name given to a serious illness that damages the body's ability to fight infections.  People with AIDS are more likely to get certain diseases and infections because their immune system cannot fight them off. The virus reduces the effectiveness of the immune system by destroying the T4 white blood cells and other cells in the body. Once the immune system is damaged, a number of opportunistic infections can occur such as PCP (Pneumocystis Carinii Pneumonia), Karposi's sarcoma, dementia and CMV (cytomegalovirus). 

In the early 1980s, AIDS was identified but they didn't know what caused it.  Initially in the U.S., it appeared to only occur in homosexual men.  The virus "HIV" was identified as the cause in 1983. 

There is no known cure to HIV/AIDS, but there are many treatments that allow a person to live with the virus and maintain a decent quality of life.  There are now many long-term survivors living with the virus and there is much hope for their continued survival. 

AIDS is caused by HIV, the Human Immunodeficiency Virus. HIV attacks the immune system - the body's defense against disease. People who have the virus are said to be HIV positive. Because HIV can live in the body for years without obvious effects, many people with HIV remain feeling healthy.
 

  • You can have HIV and not know it.
  • Your sex partner can have HIV and not know it.
  • Anyone who has HIV can give the virus to someone else.

Avoiding HIV

HIV is transmitted in infected semen, pre-ejaculate, vaginal secretions, or blood.  It can get into the body during birth if the mother has been exposed, or through contact with the penis, vagina, anus or any open cuts or sores. 

Most HIV infection occurs during unprotected intercourse (anal, oral, or vaginal sex without a condom or other barrier).  Oral sex can transmit the virus but at a much lower rate compared with other sexual acts. 

Practicing safe sex can prevent HIV infection.  Discussing safe sex is often difficult and practicing it can at first be even more difficult.  Learning how to enjoy one's sexuality with safe sex can be complicated but it is vitally important. 

Sharing needles and works (drug paraphernalia) when injecting drugs or steroids is another high risk activity for HIV infection.  The infected blood gets directly into the bloodstream. Sharing needles used for body piercing or tattooing may also pose a risk.  You can avoid HIV infection by using a syringe once and only once. When you don't share your needle you don't run the risk of either passing on or contracting any diseases. Sterile, never-used needles and syringes are safer than bleach-disinfected, previously used needles and syringes.

The Basic Rules

HIV (the AIDS virus) is spread by:
  • semen (cum)
  • vaginal fluids
  • blood passing from one person with HIV into the body of another person
The major ways in which the AIDS virus (HIV) is passed on are:
  • unsafe sex
  • sharing needles/syringes
  • from mother to child during pregnancy or birth, or through breast feeding.

Safer Sex

Safer sex is a way to have the joy of sex while reducing the possibility of catching HIV and other sexually transmitted diseases.  Practicing safe sex doesn't guarantee you will not catch HIV, but it does reduce the risk enormously. Various activities are rated by the risk associated with them.  It's not who you are but what you do that places you at risk for HIV infection. 

The main rule to remember is try to avoid exchanging bodily fluids, such as blood, semen, pre-cum and vaginal fluids. These fluids can get into the body through the linings of the vagina and the rectum, the tip of the penis and through open sores and cuts. In the mouth they can enter through cuts and ulcers. 

No risk activities include hugging, kissing, touching, mutual masturbation. 

Oral sex is considered a low to moderately risky activity.  Avoid oral sex if you have mouth ulcers or bleeding gums, or if you have just brushed your teeth.  It is suggested that you always use a condom or dental dam for oral sex to reduce this risk.  It is also suggested that you avoid getting semen and vaginal fluids in your mouth.  If you swallow semen (cum), HIV is rapidly killed by stomach acids, though it can enter open wounds that might be present before that happens. 

Anal and vaginal intercourse are high risk activities.  There is danger to both partners because the virus can travel in either direction through pre-cum, cum, blood, and other body fluids.  The virus cannot get through a condom.  Using condoms properly is the best protection if you are having vaginal or anal intercourse.  Most HIV+ people in the world have been infected through vaginal sex.

Call an AIDS educator, such as through the CDC's National AIDS Hotline, to discuss the risks and to ask questions.

Safer sex is any sexual activity which does not allow semen, vaginal fluid or blood to pass from one person into the body of another.  This information is designed to help you and your partner(s) prevent new infections with HIV.

Kissing.

Dry kissing does not involve semen, vaginal fluids or blood exchange.  Saliva does not transmit AIDS.

Mutual Masturbation.

All forms of sexual enjoyment with only skin-to-skin contact and no contact with open wounds, such as massage and body stroking, have no risk.  The only risks associated with mutual masturbation are if there are cuts or sores on the hands and/or the penis or vagina, or if cum, precum or vaginal fluids gets into the opening of the penis or into the vagina. 

Docking (rubbing your penis underneath a partners foreskin) is a risk for HIV as well as other sexually transmitted diseases.

Receptive Anal Sex. (Another person's penis in your ass/rectum)

This is a major way HIV is passed on. Infected semen can enter the blood stream through the lining of the rectum.

Insertive Anal Sex. (Your penis in another's ass/rectum)

HIV can be passed on from the passive/receptive partner to the active/insertive partner during anal sex. From the lining of the rectum the virus can come into contact with the penis and get in through tiny cuts or through the opening of the penis.

Receptive Vaginal Sex. (A penis in your vagina)

HIV can be present in semen. The virus can be passed from men to women during intercourse.

Insertive Vaginal Sex.  (Your penis in a woman's vagina)

HIV can be present in vaginal fluids. The virus can be passed from women to men during intercourse. Worldwide, most cases of HIV have been transmitted through vaginal sex.

Coitus Interuptus. (Withdrawing before ejaculation/cumming)

HIV can be passed on to both partners during intercourse. Ejaculation is not essential for the virus to be passed on. The virus can still be passed on because blood, or vaginal fluids may enter tiny cuts or the opening of the penis. Al so the virus may be in precum.

Oral Sex. (Contact between the mouth and penis: fellatio; also contact between the mouth and vagina: cunnilingus)

Although other sexually transmitted diseases can be easily contracted through oral sex, oral sex is low-moderate risk for HIV. 

There are cases where people have been infected with HIV through taking semen or vaginal fluids (and possibly menstrual blood) into their mouths.  If there is any bleeding, gum disease or other infections in the mouth, you should take extra care. 

To make oral sex even safer for HIV, and to guard against other sexually transmitted diseases, you can use barriers such as condoms for fellatio, or latex "dental dams" or plastic cling wrap for cunnilingus. Take care to avoid tears if using thin plastic film.

Rimming. (Contact between the mouth and the anus/rectum)

Rimming itself is a low risk activity for passing on HIV, but many other serious illnesses, like Hepatitis, are easily passed on this way.  You can use a clear plastic sheet to help guard against infection.

Toys.

If toys are shared during sex it is possible that semen, vaginal fluid or blood may be passed from person to person.  Don't share toys or equipment.  Keep your own toys, use a new condom on them, or wash them carefully after each person uses them.

Fingering & Fisting.

Putting fingers or the hand into the anus or vagina can be safe against HIV transmission.  But you must guard against possible damage to the vaginal or anal lining which would make transmission os HIV during intercourse later on more likely.  Damaged skin - cuts, rashes or sores - on the hand should not come into contact with body fluids.  Use latex gloves and plenty of condom-safe lubricant.

Douches & Enemas.

Washing the anus or vagina can weaken the natural defenses of the lining, making it easier for the virus to cross.  Douche and enema equipment should not be shared without thorough cleaning with bleach between uses.

Condoms.

Condoms are usually used for anal or vaginal sex, but can also be used for oral sex. It is important to use a condom the right way.   Condoms, if used properly, are a good way of reducing the risks of anal or vaginal sex.  Laboratory tests show that HIV is not passed through a latex condom.
 
 
  • Use a condom of high quality
  • Check the expiration date
  • Choose a condom that suits for size and shape
  • Practice with different condoms for size, shape and comfort, and to get used to the feel of them
  • Put the condom on before intercourse starts
  • Carefully open the condom package and to remove the condom being careful not to damage it.
  • Squeeze the air out of the tip of the condom before rolling it on.   Place the condom against the head of the erect penis, leaving about 1 cm (1/2 inch) of space at the end by gently squeezing the end of the condom to remove air from the tip.  Hold the tip of the condom and unroll it to the base of the penis. 
  • If uncircumcised, pull back the foreskin before unrolling the condom.
  • Roll it all the way to the base of the penis 
  • Use plenty of water-based lubricant, such as Wetstuff, KY, Surgilube, Muko, Lubafax or Climax.  Apply plenty of lube to the condom and the anus or vagina.  Do not use lubricants containing oil, such as Vaseline or baby oil, as they weaken the condom and may lead to holes and breaks.  Many condoms are pre-lubricated, but this is often not sufficient.  If there is not enough lubrication during sex, it increases friction and the likelihood of the condom breaking.  Add more water-based lubricant as needed.
  • Check the condom frequently during sex to make sure that it hasn't slipped off or broken.
  • After ejaculating, hold the base of the condom to keep it from coming off and remove the erect penis from your partner.    Some people choose to withdraw prior to cumming as an added precaution.
  • Only use the condom once.  Never re-use them!
  • Wrap the condom and dispose of it in the trash.
  • Do not store condoms in your wallet or glove box, or near excess heat or cold, nor in places where sharp objects might damage them.  Use condoms within a year or two of the date of manufacture.
Condoms are extremely reliable. They usually only break when they are fitted incorrectly, they become damaged, or there is not enough lubricant. Neither sperm, nor the viruses and bacteria that cause HIV and other sexually transmitted diseases can penetrate an intact latex condom.  If your condom does break, withdraw carefully and immediately. 

If you have never used a condom before you might like to practice putting one on by yourself before trying it with a partner.  It will be easier in the heat of the moment.  Condoms are an important part of safe sex.
 


Getting Tested

Get tested for HIV regularly if your are sexually active.  Your doctor or a clinic can give you advice about getting tested.  Find a doctor or clinic where you feel comfortable discussing this matter.  If you are not comfortable discussing this with your family doctor you may prefer to call an AIDS hotline (several are available through LAMBDA Line, 915.562.GAYS) or you might go to another doctor or a health or HIV clinic.  HIV clinics often allow you to be totally anonymous. Contact your local HIV/AIDS body or counseling service to find out where to go close to you. 

Testing for HIV infection often involves collecting a blood sample which is tested to see if it contains HIV antibodies. It takes a week or two before you get your results. Results are not usually given out over the phone and a good doctor or clinic will make sure that both pre- and post-test counseling is given.  There are home HIV test kits and rapid HIV tests that your doctor or clinic can tell you about.

Once a person is exposed to HIV, it takes between six and twelve weeks (called a "window period") before the body produces antibodies to the virus. This is what HIV tests look for.  Before this antibody is produced, tests will not show if you are infected with HIV. 

If you are positive, there are treatments available which can slow down the progress of the virus.  You can also ensure your sexual behavior does not put sexual partners at risk of infection.  If you are tested and the result is negative, the relief you feel may inspire to remain that way by ensuring you practice safer sex.