PrEP

We’ve learnt a lot about HIV in the last few decades. What was an untreatable illness that wasn’t simple to detect in the 1980s, advances in technology mean that, today, HIV is much easier to identify, prevent and manage.

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Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
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Ways to prevent HIV through sex

The most common way for HIV to be transmitted is through unprotected sex, and there are lots of ways to ensure that you can limit its spread. There are lots of good behavioural HIV prevention strategies that can be used to ensure that you’re safe and taking good care of yourself.

It’s important to remember that whilst you can get HIV from unprotected sex, you can’t get it from simple, casual contact with someone else that has the infection. Handshakes, kisses and hugs don’t spread the virus. More intimate sexual contact such as oral sex or masturbation are safer options of closer contact, with less risks.

When you’re considering what you need to do to take care of your health in terms of HIV protection, it’s always best to use more than one preventative method, as no one single protection strategy works 100% on it’s own . Some will vary in effectiveness, and work better when used with others. Using barrier methods of protection like condoms is often a first step, but there are other options to consider as well.

Condoms can have a high rate of effectiveness in preventing HIV transmission, but they also protect you from other STIs when they’re used correctly. There are two different types of condoms: one which goes directly over the penis and one which goes into the vagina. Both are just as effective as each other when they’re used as a HIV prevention method.

It’s important to ensure that condoms are used correctly to prevent an HIV infection. For instance, if you’re having sex and you notice that the condom splits or breaks, it should be replaced immediately before you continue. Condoms should never be reused, and they should always be wrapped safely and disposed of carefully after use.

You should also use a condom every time you have sex with a new partner, unless you’re sure that you’re both free from STIs. No barrier method of protection such as condoms will be 100% effective at preventing the transmission of HIV when used on their own.

When condoms are used correctly, they’ll offer both partners up to 90% protection against HIV, so in rare cases they might not work. The main reason they fail is if they’re only put on partway through having sex, or if there’s no space left at the tip for semen to go in to. Rips, tears and damage can also occur if they’re not stored or put on correctly.

An effective way of preventing the spread of HIV through sex or intravenous transmission (injecting) is through the use of a medication known as PrEP (Pre-Exposure Prophylaxis). It’s used as an HIV prevention drug and works to stop the virus from surviving in your body if you’re exposed to it.

PrEP has to be taken correctly in order for you to get the most benefit from it. For instance if you’re in a relationship with a partner who’s HIV positive, you should take PrEP daily. The second way of taking PrEP is what’s known as ‘event dosing’ (otherwise known as ‘on-demand’) to prepare yourself. You’d use this method if you know you’re going to have sex with someone who is either HIV positive or has an unknown HIV status.

HIV prevention drugs like PrEP won’t stop HIV from developing if you’ve already been exposed.

If you’ve already been exposed to HIV then you should use alternative treatments to stop HIV from developing or spreading.

When to use PEP

If you might’ve already been exposed to HIV and there’s a risk of it developing, then PrEP medications won’t be suitable for you. In cases like this, you’ll need to ask for advice on using PEP instead. These are medications that can be taken after exposure, but they should be used within 72 hours of having unprotected sex.

As a method of preventing HIV transmission, PEP (known as Post-Exposure Prophylaxis) shouldn’t be used on its own where possible, as it isn’t as effective as other prevention methods – such as using condoms and PrEP together. If you’ve been exposed to HIV and are currently taking PEP, you’ll still need to practice safe sex with barrier protection.

PEP is an option to explore for treatment if you feel as though you might have been exposed to HIV, but should be taken within 72 hours of the possible exposure. If you think you’ve left it longer than 3 days, then speak to a GP or clinician about your options.

On its own, lubricant can’t prevent HIV transmission. However, it can make sex safer by reducing the risk of your condom tearing. It can also decrease the chances of vaginal or anal tears or scratches, as lubricants prevent dryness and friction from occurring .

It’s important to use the right kind of lubricant. Choose water based options only (such as K-Y Jelly) rather than anything oil or petroleum based (like Vaseline or baby oil). Anything oil based will degrade and weaken the latex rubber used in condoms and can cause them to break or tear much more easily. Water-based lubricants are designed for use on the sensitive skin of the genital and anal areas and so will feel kinder on those parts of the body.

Practising safe sex can help. If you’re having sex with a new partner then it’s important to recognise that the riskiest way for HIV to be transmitted is through unprotected anal or vaginal sex. Oral sex and mutual masturbation are safer methods of sexual contact.

If you have multiple or different sexual partners, you’re more at risk of getting or transmitting HIV than if you don’t take any precautions at all. The simple act of using a condom and lubricant together can help to keep you healthy, safe and still allow you to enjoy intimacy when you like.

Knowing your own and your partner’s HIV or STI status is really important so you can understand what protection methods you need to use in order to reduce transmission and risks of getting HIV.

If you know you’re at risk of getting HIV, then it’s important to get regular tests to make sure you’re safe and healthy . If you already have another STI then your risk of getting HIV is increased, so it’s good to get yourself tested regularly in these cases as well.

If you’re engaging in sex with someone whose STI or HIV status is unkown, then it’s always best to protect yourself by using a condom and lubricant.

Medications such as PrEP can be used as a form of ‘on demand’ protection if you know you’re going to have sex with someone who might have HIV. You can discuss how to take it for this reason with your clinician. However it’s worth noting that it’s only recommended for men who are going to have sex with other men. At the moment there is no clinical data on the effectiveness of on-demand dosing for receptive vaginal sex.

If you’re already taking PrEP as a daily medication, then it’s recommended that you have a HIV test every three months as part of your treatment. This is because if you develop HIV you’ll need to stop taking PrEP and discuss your other treatment options with your clinician.

Ways to prevent HIV through injection

Needle use is another common way of transmitting or catching HIV. It’s also one of the ways of contracting Hepatitis C. Injecting drugs presents a risk of getting either condition. There’s also a small risk of contracting both of these from tattoos as well, especially if the tattoo artist doesn’t follow correct hygiene procedures.

PrEP can be used as a preventative treatment if you aren’t HIV positive and want to avoid the risks of getting HIV from using needles to inject drugs.

The safest way of protecting yourself and others from the risks associated with HIV, if you’re injecting, is to have your own needles and syringes and never to share them with anyone. You should always avoid using anyone else’s needles or equipment as well.

If your only option is to share a needle with someone else, it’s important that the needle is sterilised with bleach and boiling water in between uses. This isn’t as effective as choosing not to share needles at all. It will only slightly decrease your risk of getting HIV.

It can be useful to look at other methods of taking drugs if you can. For instance, if you’re a heroin user, then one of the best ways forward is to speak to a healthcare advisor about enrolling on a methadone programme.

Methadone can be taken in liquid form and doesn’t need to be injected. You can also use these programmes to gradually withdraw from drug use, too – if you’re looking to the future and would like to quit.

If you want to get a tattoo, then make sure that you choose a safe, reputable artist who follows health and safety guidelines to keep you and the salon safe.

If you have any doubts about the cleanliness or hygiene standards of a tattoo salon then it’s best to avoid that one, and look for somewhere else. Anyone who works as a professional artist will want to keep themselves and all their clients as safe as possible.

The tattoo artist should always use a clean, sterile needle for any work anywhere on your body. Always look for recommendations of trusted businesses before you commit.

How to not spread HIV when you have it

All of the above methods can help to ensure that if you’re living with HIV, that you don’t transmit the virus to anyone else.

If you’ve been diagnosed with HIV then you’ll need to start taking Antiretroviral Therapy (ART). You can discuss this with your clinician. ART is a form of medication that you can take which will reduce the amount of virus that’s in your system to a level that means you can’t pass it on to anyone else.

You’ll need to take it for around six months for this to happen, and you should still practice safe sex at all times, to protect you and any sexual partners you may have during this time.

If you’ve been undergoing Antiretroviral Therapy for HIV treatment, after a certain time your viral load will become so low that it’s undetectable. This means that you won’t be able to pass it on to others and it’s unlikely to affect your health.

However, this doesn’t mean that you’re cured, and you’ll still need to continue with your treatment. If you stop taking Antiretroviral medication the levels of virus in your system will increase and you’ll be able to pass on HIV again.

If you have a partner, it’s advisable for them to start using daily PrEP as a precautionary measure to make sure that they aren’t exposed to HIV. It’s always good advice to use barrier methods of protection, such as condoms, when you’re having sex as well.

HIV can be passed on from mother to baby, either via pregnancy or breastfeeding. If you’re pregnant or have given birth and you think you might have been exposed to HIV, or are at a greater risk of getting HIV, then it’s important to get tested as soon as possible. This is so that if you or your child need treatment it can begin quickly.

Treating HIV as quickly as possible will greatly reduce the risk of the baby getting HIV. If you’re at risk of HIV exposure and are pregnant, it’s worth talking to a clinician about taking PrEP to further reduce your risks.

Pregnant women who have HIV and are due to give birth might be advised to deliver their baby via C-Section to further help with the prevention of mother-to-child transmission of HIV, and you might need to give your baby HIV medication for 4-6 weeks after they’ve been born.

You’ll also need to bottle-feed your baby if you’re HIV positive, or there’s a risk that you might be.

Studies have shown that you’re less likely to catch HIV if you’ve been circumcised, but whether you’re circumcised or not you should always make sure that you practise safe sex to keep the risks of getting HIV or passing it on as low as possible. Condoms are a safe and reliable choice of protection, and making sure they’re used correctly is key .

If you’re circumcised and already have HIV then it’s not going to be very effective at reducing transmission. So you’ll still need to practice safe sex, alongside regular testing, to make sure that you stay in good health.

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This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2024.

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When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

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