June 27, 2014
Today, more tools than ever are available to prevent HIV. In addition to limiting your number of sexual partners, never sharing needles, and using condoms correctly and consistently, you may be able to take advantage of newer biomedical options such as pre-exposure and post-exposure prophylaxis.
Choose less risky sexual behaviors, limit your number of sex partners, use condoms, use medicines to prevent HIV if appropriate, and get checked for sexually transmitted diseases (STDs). The more of these actions you take, the safer you can be.
Specifically, you can:
Avoid having your partner ejaculate in your mouth, and use barriers such as condoms, natural rubber latex sheets, dental dams, or cut-open non-lubricated condoms between your mouth and your partners' genitals.
Oral sex involves giving or receiving oral stimulation to the penis (fellatio), the vagina (cunnilingus), or the anus (anilingus or rimming). Most types of oral sex carry little to no risk of HIV. Your highest oral sex risk is performing oral sex (fellatio) with ejaculation in your mouth. However, the risk is still low, and much lower than 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 sexually transmitted diseases (STDs) (which may or may not be visible).
The risk is lower if the partner with HIV is taking antiretroviral therapy (ART) consistently and correctly, and if the partner who is HIV-negative is taking pre-exposure prophylaxis (PrEP) consistently and correctly. Condoms and HIV medicines can greatly lower the risk of transmitting HIV.
Keep in mind that barrier methods are the only way to protect you from some STDs, including gonorrhea of the throat. And although the chance of getting or transmitting HIV from anilingus (rimming) is small, there is a big chance of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming. There are effective vaccines that protect against hepatitis A and B and human papillomavirus infections. Talk to your health care provider to see if these are right for you, if you have not already been vaccinated.
For more information, see Oral Sex and HIV Risk.
When used correctly and consistently, condoms are highly effective in preventing HIV infection.
Condoms are also effective at preventing sexually transmitted diseases (STDs) transmitted through body fluids, like gonorrhea, chlamydia, and HIV. However, they provide less protection against STDs spread through skin-to-skin contact like human papillomavirus (genital warts), genital herpes, and syphilis.
There are two types of condoms: male and female.
Although highly effective when used consistently and correctly, there is still a chance of getting HIV if you only use condoms, so adding other prevention methods can further reduce your risk (see "How can I prevent getting HIV from anal or vaginal sex?").
Yes, because lubricants can help prevent condoms from breaking.
Water-based and silicon-based lubricants are safe to use with latex condoms. Oil-based lubricants and products containing oil, such as hand lotion, Vaseline, or Crisco should not be used with latex condoms. It is safe to use any kind of lubricant with nitrile female condoms.
Male circumcision reduces the risk that a man will get HIV from an infected female partner, and also lowers the risk of other sexually transmitted infections (STIs), penile cancer, and infant urinary tract infection. Studies have not consistently shown that it prevents HIV among men who have sex with men. Circumcision is only partly effective and should be used with other prevention measures. Men who are considering circumcision should weigh its risks and costs against its potential benefits. For more information on male circumcision and HIV, see CDC's male circumcision site.
Pre-exposure prophylaxis, or PrEP, can lower the risk of getting HIV by taking a pill every day. It is for people who do not have HIV but who are at substantial risk of getting it.
CDC recommends that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.
For sexual transmission, this includes anyone who is in an ongoing relationship with an HIV-positive partner. It also includes anyone who 1) is not in a mutually monogamous* relationship with a partner who recently tested HIV-negative, and 2) is
For people who inject drugs, this includes those who have injected illicit drugs in the past 6 months and who have shared equipment or been in drug treatment for injection drug use in the past 6 months.
For heterosexual couples where one partner has HIV and the other does not, PrEP is one of several options to protect the uninfected partner during conception and pregnancy.
People who use PrEP must be willing to take the drug every day and to return to their provider every 3 months for a repeat HIV test, prescription refills, and follow-up.
Some people on PrEP may have side effects like an upset stomach or loss of appetite but these are mild and usually go away in the first month.
* Mutually monogamous means that you and your partner only have sex with each other and do not have sex outside the relationship.
Yes. >Post-exposure prophylaxis (PEP) is medicine that can prevent HIV after a possible exposure if started within 3 days.
An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is HIV-positive or whose HIV status you don't know. You take PEP for 4 weeks if you may have been recently exposed to HIV and are not on PrEP. PEP keeps HIV from making copies of itself and turning into infection. To be effective, PEP must begin as soon as possible, but always within 72 hours (3 days) of a possible exposure. Keep in mind that PEP should only be used in situations right after a potential exposure. PEP is not intended for long-term use. It is not a substitute for other proven HIV prevention methods, such as correct and consistent condom use.
You should continue to use condoms with sex partners while taking PEP. If you have repeated exposures to HIV, you should consider PrEP.
No. There is currently no vaccine that will prevent HIV infection or treat those who have it.
No. Microbicides are gels, films, or suppositories that can kill or neutralize viruses and bacteria. Researchers are studying both vaginal and rectal microbicides to see if they can prevent sexual transmission of HIV, but none are currently available for use.
Specifically, you can:
You should also encourage your partners who are HIV-negative to get tested for HIV at least once a year so they are sure about their HIV status and can take action to keep them healthy. They may benefit from more frequent testing (e.g., every 3-6 months). (See "When should I get tested?" below). To find a testing site near them, they can call 1-800-CDC-INFO (232-4636), visit HIVtest.cdc.gov, text their ZIP code to KNOW IT (566948), or use a home testing kit.
If you believe you cannot stop injecting drugs yet, use only sterile injection equipment and water, never share injection equipment, and use medicines to prevent HIV if appropriate. The more of these actions you take, the safer you can be.
Injecting drugs, including hormones, steroids, or silicone, can transmit HIV directly through needles or equipment (works). In addition, some drugs, such as methamphetamine, cocaine, or alcohol, may put you at risk for HIV by lowering your inhibitions and making you more likely to engage in risky behavior.
The best way to reduce your risk of HIV is to stop using drugs. If you cannot stop using drugs, talk with your doctor or health care provider, counselor, loved one, or someone else you trust about getting into a treatment program. Find a treatment facility near you or call 1-800-662-HELP (1-800-662-4357).
If you are injecting drugs and believe you cannot stop using yet, here are some other ways to reduce your risk of getting HIV or spreading it to others:
These steps, promoted in prevention programs for substance users, have helped decrease the new cases of HIV resulting from injection drug use in recent years.
One additional prevention note: If you are likely to be in a situation where alcohol and other kinds of drugs will be used, have a condom with you in case you have sex.
If you are HIV-positive, you can greatly lower your risk of transmitting HIV to your baby by taking antiretroviral drugs during pregnancy, labor, and delivery; having a C-section; and avoiding breastfeeding.
Get tested for HIV when you are planning a pregnancy or as soon as possible after you find out you are pregnant.
If you are HIV-negative but your partner has HIV, ask your health care provider about pre-exposure prophylaxis (PrEP), a daily pill that can prevent HIV during conception and pregnancy. Encourage your partner to get and stay on treatment with antiretroviral therapy, which greatly reduces the chance that he will pass HIV to you.
If you are HIV-positive, the right prevention steps can lower your risk of giving HIV to your baby from 20% (no prevention steps) to 2% (if you receive antiretroviral drugs during pregnancy, labor, and delivery; have your baby by cesarean, or C-section; and avoid breastfeeding). Newborn babies born to HIV-infected mothers are also given medicine to protect them.
You should be tested again in your third trimester if you engage in behaviors that put you at risk for HIV.
Of course, some women do not find out they are HIV-positive until they are already in labor. But if they receive antiretroviral drugs during labor and delivery and avoid breastfeeding, the chance of passing the infection to the baby can still be significantly decreased.
For more information, see CDC's HIV Among Pregnant Women, Infants, and Children.