Sex

You have the right to pursue a happy, safe and fulfilling sex life. That means being free to enjoy a range of sexual activities, and being free to not have sex, with the partner or partners of your choice.

Protecting your sex partners from HIV acquisition, means using condoms and water-based lubricant when you have vaginal or anal sex with men.

Using condoms and lubricant also protects you from sexually transmissible infections (STIs [1][Sexually Transmissible (or Transmitted) Infection] Infections spread by the transfer of organisms from person to person during sexual contact. Also called venereal disease (VD) (an older public health term) or sexually transmitted diseases (STDs). ) that can compromise your health and fertility. Men transmit most STIs more effi ciently to women than women do to men, and many STIs like Chlamydia can be asymptomatic, so a person may have it and pass it on without knowing. If either you or your partner has an STI the risk of HIV transmission is increased. If you have an STI it is likely to increase the levels of HIV in your vaginal fl uids. If your partner has an STI, his or her body’s inflammatory response to an infection increases the range of target cells for HIV entry.

Safe sex also means thinking about hepatitis C (HCV [2]Hepatitis C virus.) transmission. Having HIV and HCV together makes it more likely that you can transmit HCV to your partner through sex. If you don’t have HCV but your partner does, your HIV status makes you more vulnerable to acquiring HCV. See the section on hepatitis C for more information.

Preventing HIV transmission

• HIV can only be transmitted when there is a way for the virus [3]A small infective organism which is incapable of reproducing outside a host cell. to enter
  into your partner’s bloodstream or lymphatic system, where HIV is present in a high enough quantity for infection to occur.
• The risks of HIV transmission increase when either of the sexual partners has any kind of sexually transmissible infection.
• The risks of transmission also increase when a person has very recently been infected with HIV (primary infection).
• Using condoms and lubricant for sexual intercourse (whether vaginal or anal) protects your partner from acquiring HIV. Sexual intercourse without condoms and lubricant is the most likely route of sexual transmission from a woman to a man, whereas other forms of sex are relatively safe.
• If your partner has open wounds, cold sores (herpes simplex) or has had very recent dental surgery, or if you have genital ulcers or lesions, you need to consider using barriers for oral sex, or not having oral sex until your partner’s wounds have healed.
• If you practice S&M activities that might draw blood you need to ensure that all equipment is properly cleaned and disinfected after use, and not shared.

Common infections increase transmission risks

Any infection that you have in the genital tract such as thrush (candida), herpes, chlamydia, gonorrhoea or syphilis can increase your viral load [4]A measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. in your sexual fluids, making HIV transmission more likely. Similarly, if your HIV-negative partner, whether male or female, has a genital infection it makes them more vulnerable to HIV infection.

Sexual health screening and prompt treatment for any sexually transmissible infection is important for your sexual health, and for your partner.