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Basic Questions and Answers About HIV Prevention

March 10, 2016

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HIV Prevention Basic Questions and Answers

Today, more tools than ever are available to prevent HIV. In addition to abstinence, limiting your number of sexual partners, never sharing needles, and using condoms the right way every time you have sex, you may be able to take advantage of newer medicines such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).


Is Abstinence the Only 100% Effective HIV Prevention Option?

Yes. Abstinence means not having oral, vaginal, or anal sex. An abstinent person is someone who's never had sex or someone who's had sex but has decided not to continue having sex for some period of time. Abstinence is the only 100% effective way to prevent HIV, other sexually transmitted diseases (STDs), and pregnancy. The longer you wait to start having oral, vaginal, or anal sex, the fewer sexual partners you are likely to have in your lifetime. Having fewer partners lowers your chances of having sex with someone who has HIV or another STD.

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC's HIV Risk Reduction Tool (BETA).


How Can I Prevent Getting HIV From Anal or Vaginal Sex?

Use condoms the right way every time you have sex, take medicines to prevent or treat HIV if appropriate, choose less risky sexual behaviors, get tested for other sexually transmitted diseases (STDs), and limit your number of sex partners. The more of these actions you take, the safer you can be.

Specifically, you can:

  • Use condoms the right way every time you have sex (see How well do condoms prevent HIV?). Learn the right way to use a male condom.
  • Reduce your number of sexual partners. This can lower your chances of having a sex partner who will transmit HIV to you. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission.
  • Talk to your doctor about pre-exposure prophylaxis (PrEP), taking HIV medicines daily to prevent HIV infection, if you are at very high risk for HIV. PrEP should be considered if you are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner. PrEP also should be considered if you aren't in a mutually monogamous relationship with a partner who recently tested HIV-negative, and you are a:
    • gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months;
    • man who has sex with both men and women; or
    • heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at very high risk of HIV infection (for example, people who inject drugs or women who have bisexual male partners).
  • Post-exposure prophylaxis (PEP) means taking HIV medicines after being potentially exposed to HIV to prevent becoming infected. If you're HIV-negative or don't know your HIV status and think you have recently been exposed to HIV during sex (for example, if the condom breaks), talk to your health care provider or an emergency room doctor about PEP right away (within 3 days). The sooner you start PEP, the better; every hour counts. If you're prescribed PEP, you'll need to take it once or twice daily for 28 days. Keep in mind that your chance of getting HIV is lower if your HIV-positive partner is taking medicine to treat HIV infection (called antiretroviral therapy, or ART) the right way, every day and his or her viral load remains suppressed.
  • Get tested and treated for other STDs and encourage your partners to do the same. If you are sexually active, get tested at least once a year. Having other STDs increases your risk for getting or transmitting HIV. STDs can also have long-term health consequences. Find an STD testing site.
  • If you're HIV-negative and your partner is HIV-positive, encourage your partner to get and stay on treatment. If taken the right way, every day, the medicine to treat HIV (ART) reduces the amount of HIV (called "viral load") in the blood and elsewhere in the body to very low levels. This is called "viral suppression." Being virally suppressed is good for an HIV-positive person's overall health and greatly reduces the chance of transmitting the virus to a partner.
  • Choose less risky sexual behaviors. HIV is mainly spread by having anal or vaginal sex without a condom or without taking medicines to prevent or treat HIV.
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Anal sex is the riskiest type of sex for transmitting HIV. It's possible for either partner -- the partner inserting the penis in the anus (the top) or the partner receiving the penis (the bottom) -- to get HIV, but it is much riskier for an HIV-negative partner to be the receptive partner. That's because the lining of the rectum is thin and may allow HIV to enter the body during anal sex.

Vaginal sex also carries a risk for HIV transmission, though it is less risky than anal sex. Most women who get HIV get it from vaginal sex, but men can also get HIV from vaginal sex.

In general, there is little to no risk of getting or transmitting HIV from oral sex. Theoretically, transmission of HIV is possible if an HIV-positive man ejaculates in his partner's mouth during oral sex. However, the risk is still very low, and much lower than with anal or vaginal sex. Factors that may increase the risk of transmitting HIV through oral sex are oral ulcers, bleeding gums, genital sores, and the presence of other STDs, which may or may not be visible. See How can I prevent getting HIV from oral sex?

Sexual activities that don't involve contact with body fluids (semen, vaginal fluid, or blood) carry no risk of HIV transmission but may pose a risk for other STDs.

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC's HIV Risk Reduction Tool (BETA).


How Can I Prevent Getting HIV From Oral Sex?

In general, there is little to no risk of getting or transmitting HIV from oral sex. Theoretically, transmission of HIV is possible if an HIV-positive man ejaculates in his partner's mouth during oral sex. However, the risk is still very low, and much lower than with anal or vaginal sex.

Oral sex involves putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (anilingus). There's little to no risk of getting or transmitting HIV through oral sex. Factors that may increase the risk of transmitting HIV through oral sex are oral ulcers, bleeding gums, genital sores, and the presence of other sexually transmitted diseases (STDs), which may or may not be visible.

While there is little to no risk of getting HIV from oral sex, using a barrier (for example, a condom, dental dam, or cut-open nonlubricated condom) can further reduce your risk of getting or transmitting HIV and protect you and your partner from some other STDs, including gonorrhea of the throat and hepatitis.

The risk is also lower if the HIV-positive partner is taking medicine to treat HIV (called antiretroviral therapy or ART), or if the HIV-negative partner is taking medicine to prevent HIV (called pre-exposure prophylaxis or PrEP). Both PrEP and ART need to be taken the right way every time in order to work.

Because your mouth may come into contact with feces or other body fluids during oral sex, it is important that you talk to a health care provider about your chances of getting hepatitis A and B. If you've never had hepatitis A or B, there are vaccines to prevent them. Your provider can help you decide if vaccination is right for you.

For more information, see Oral Sex and HIV Risk.

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC's HIV Risk Reduction Tool (BETA).


How Well Do Condoms Prevent HIV?

If you use them the right way every time you have sex, condoms are highly effective in preventing HIV infection. But it's important to educate yourself about how to use them the right way.

Condoms can also help prevent other sexually transmitted diseases (STDs) you can get through body fluids, like gonorrhea and chlamydia. However, they provide less protection against STDs spread through skin-to-skin contact, like human papillomavirus or HPV (genital warts), genital herpes, and syphilis.

There are two main types of condoms: male and female.


Male Condoms

  • A male condom is a thin layer of latex, polyurethane, polyisoprene, or natural membrane worn over the penis during sex. Learn the right way to use a male condom.
  • Latex condoms provide the best protection against HIV. Polyurethane (plastic) or polyisoprene (synthetic rubber) condoms are good options for people with latex allergies, but plastic ones break more often than latex ones. Natural membrane (such as lambskin) condoms have small holes in them, so they don't block HIV and other STDs.
  • Use water- or silicone-based lubricants to lower the chances that a condom will break or slip during sex. Don't use oil-based lubricants (for example, Vaseline, shortening, mineral oil, massage oils, body lotions, and cooking oil) with latex condoms because they can weaken the condom and cause it to break. Don't use lubricants containing nonoxynol-9. It irritates the lining of the vagina and anus and increases the risk of getting HIV.


Female Condoms

  • A female condom is a thin pouch made of a synthetic latex product called nitrile. It's designed to be worn by a woman in her vagina during sex.
  • When worn in the vagina, female condoms are comparable to male condoms at preventing HIV, other STDs, and pregnancy. Some people use female condoms for anal sex. We don't currently know how well female condoms prevent HIV and other STDs when used by men or women for anal sex. But we do know that HIV can't travel through the nitrile barrier.
  • It is safe to use any kind of lubricant with nitrile female condoms.

Even if you use condoms the right way every time you have sex, there's still a chance of getting HIV. For some individuals at high risk of getting or transmitting HIV, adding other prevention methods, like taking medicines to prevent and treat HIV, can further reduce their risk (see How can I prevent getting HIV from anal or vaginal sex?).

Learn more about how to protect yourself, and get information tailored to meet your needs from CDC's HIV Risk Reduction Tool (BETA).

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