GEARING-UP FOR MIXED-STATUS SEX

People with different HIV status’ can have amazing, sexual lives. 

You and your partner(s) should learn about all the available prevention options and make the decisions that are right for both of you. Below, you’ll find ways you and your partner can protect each other from HIV and other STIs:

Use condoms the right way every time you have sex.

    • Using condoms when you have anal or vaginal sex can help protect you and your partners from HIV and other sexually transmitted diseases (STDs). If used the right way every time you have sex, condoms are highly effective in preventing HIV infection. But condoms can sometimes break or come off during sex. Using a water-based or silicone lubricant can help prevent condoms from breaking or slipping. Learn how to use condoms correctly and talk with your partner about condoms and safer sex.

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. There is extremely low to no risk of getting HIV through oral sex. Sexual activities that don’t involve contact with  body fluids  (i.e., semen, vaginal fluid, or blood) carry no risk of HIV transmission.

Reduce the number of people you have sex with.

    • Having multiple sex partners increases your risk for HIV and for other STDs.

If you’re HIV-negative, consider pre-exposure prophylaxis (PrEP), taking HIV medicines daily to prevent HIV infection. If taken daily, PrEP is highly effective for preventing HIV from sex or injection drug use. But it’s much less effective if you don’t take it consistently.

    • PrEP is recommended for people who are HIV-negative and at risk for getting the virus from sex or injection drug use.  This includes
      • Have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load)
      • Have not consistently used a condom
      • Have been diagnosed with a sexually transmitted disease (STD) in the past 6 months
    • For people who inject drugs, this includes those who have an injection partner with HIV, or have shared needles, syringes, or other injection equipment .

If you’re HIV-negative, talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a recent possible exposure to HIV.

    • An example of a possible exposure is if you have anal or vaginal sex without using a condom, or the condom breaks or slips while having sex, with someone who has or may have HIV, and you’re HIV-negative and not taking PrEP. Starting PEP immediately and taking it daily for 28 days reduces your chance of getting HIV.

If your partner with HIV is taking HIV medicine as prescribed and keeps an undetectable viral load, they have effectively no risk of transmitting HIV to you through sex.

Get tested and treated for other STDs and encourage your partners to do the same.

  • STDs can have long-term health consequences, and they can increase your chance of transmitting HIV or getting HIV.

If you have HIV, take HIV medicine, called antiretroviral therapy (ART) to get and keep an undetectable viral load.

    • You can protect your partner from HIV if you take ART daily as prescribed AND get and keep an undetectable viral load.
    • ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. ART can reduce the amount of HIV (viral load) in the body. Taking ART as prescribed can make the viral load so low that a test can’t detect it. This is called an undetectable viral load. If a person with HIV keeps an undetectable viral load, they can stay healthy for many years and have effectively no risk of transmitting HIV through sex.

If you’re taking ART, follow your health care provider’s advice.

    • Visit your health care provider regularly and always take your medicines as prescribed.

If your partner has HIV, encourage your partner to get and stay on treatment.

    • This is the most important thing your partner can do to protect their own health. If you are HIV-negative and your partner with HIV takes their HIV medicine daily as prescribed AND is able to get and keep an undetectable viral load, there is effectively no risk of transmitting HIV to you.

If you are HIV-negative and your partner with HIV has an undetectable viral load, you or your partner may want to use additional prevention.

    • Using a condom the right way every time you have sex can protect you from other STDs. Using condoms or having the HIV-negative partner take daily medicine to prevent HIV (called pre-exposure prophylaxis or PrEP can provide added peace of mind. Also consider using additional prevention methods if the partner with HIV:
      • Is unsure, for any reason, that they have an undetectable viral load
      • Has a higher viral load (200 copies/ml of blood or greater)
      • Has trouble taking HIV medicine regularly
      • Missed some doses since their last viral load test
      • Has stopped taking HIV medicine or may do so in the future
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